Active NPI
Susan Rudofker Rudin
- Pharmacist
- Exeter, PA
National Provider Identifier
1902484439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP033853L
- Practice address
- 960 Wyoming Ave
Exeter, PA 18643-1199 - Phone
- (570) 654-7422
- NPI assigned
- Mar 29, 2021
- Last updated
- Mar 29, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP033853L | PA | Primary |
Addresses
Primary practice location
960 Wyoming Ave
Exeter, PA 18643-1199
Mailing address
16 Salem Dr
Wilkes Barre, PA 18702-7323
Phone (570) 817-3040
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP033853L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1902484439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 SALEM DR",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187027323",
"telephone_number": "570-817-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 WYOMING AVE",
"city": "EXETER",
"state": "PA",
"postal_code": "186431199",
"telephone_number": "570-654-7422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOFKER RUDIN",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP033853L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Exeter, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.