Provider Demographics
NPI:1023048337
Name:RUDNITZKY & SHUGAR MDS PA
Entity type:Organization
Organization Name:RUDNITZKY & SHUGAR MDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-6300
Mailing Address - Street 1:PO BOX 2407
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08818-2407
Mailing Address - Country:US
Mailing Address - Phone:732-494-6300
Mailing Address - Fax:732-494-1028
Practice Address - Street 1:98 JAMES ST
Practice Address - Street 2:SUITE 104
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-494-6300
Practice Address - Fax:732-494-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3001504Medicaid
NJOK9411OtherHEALTHNET
NJOK9411OtherHEALTHNET