Robert David Rudnicki, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

15878 Issued in CT

Practice address

701 Cottage Grove Rd
Ste C230
Bloomfield, CT 06002

Phone

(860) 242-5777

Fax

(860) 286-2972

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1891762902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD",
            "address_2": "STE C230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-242-5777",
            "fax_number": "860-286-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD",
            "address_2": "STE C230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-242-5777",
            "fax_number": "860-286-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICKI",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CT",
            "license": "15878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115878",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rheumatology Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Rheumatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.