Jennifer Phyllis Rudin
Individual provider Active NPI Behavior Analyst · Bardonia, NY
NPI 1871978767 · NPPES record last updated Jul 21, 2015
Key facts
- NPI
- 1871978767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 41 Jay St
Bardonia, NY 10954-2136 - Phone
- (845) 826-0293
- NPI assigned
- Jul 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
41 Jay St
Bardonia, NY 10954-2136
Mailing address
41 Jay St
Bardonia, NY 10954-2136
Phone (845) 826-0293
Other providers in Bardonia, NY
- Frank Reemer
- Nancy M Rello
- Emily Griffin Ricci
- Robert S. Kim Acupuncture Wellness Care P.C.
- Roderick James Rubi
- Staffy Sabu
- John Mina Samuel
- Schnapper Chiropractic PC
- Jeffrey Scott Schnapper
- Philip Ho Shen
All providers in Bardonia, NY · Behavior Analyst in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.