Active NPI
Ronald R Fudala, P.T., D.P.T
- Physical Therapist
- Northfield, NJ
National Provider Identifier
1730262833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01142700
- Practice address
- 1418 New Rd
Northfield, NJ 08225-1179 - Phone
- (609) 645-8282
- Fax
- (609) 645-8182
- NPI assigned
- Oct 23, 2006
- Last updated
- Feb 17, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01142700 | NJ | Primary |
Addresses
Primary practice location
1418 New Rd
Northfield, NJ 08225-1179
Mailing address
379 Sapling Way
Atco, NJ 08004-1955
Phone (856) 753-5084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01142700 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234828800000",
"number": "1730262833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 SAPLING WAY",
"city": "ATCO",
"state": "NJ",
"postal_code": "080041955",
"telephone_number": "856-753-5084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 NEW RD",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "082251179",
"telephone_number": "609-645-8282",
"fax_number": "609-645-8182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUDALA",
"first_name": "RONALD",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "P.T., D.P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2009-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01142700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, NJ
- Jonathan Lloyd Fox, MD
- Brett T. Foxman, MD
- Scott G. Foxman, MD
- Vanessa Francesco
- Fresenius Medical Care Northfield, LLC (Fresenius Kidney Care Shore)
- Melanie Fumosa, LSW
- Madelyn Funkhouser, LSW, MSSW, CADC, CTP
- Pamela Lynne Gallagher, OTR/L, CHT
- Estefania Gallegos Warrington
- Garden State Specialty Care, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.