Provider Demographics
NPI:1174697544
Name:RUDOFSKY, RHODA
Entity type:Individual
Prefix:
First Name:RHODA
Middle Name:
Last Name:RUDOFSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PETER COOPER RD
Mailing Address - Street 2:APT 13D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6723
Mailing Address - Country:US
Mailing Address - Phone:212-388-9494
Mailing Address - Fax:
Practice Address - Street 1:2 PETER COOPER RD
Practice Address - Street 2:APT 13D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6723
Practice Address - Country:US
Practice Address - Phone:212-388-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070633-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical