Rudolph, Bryan

Rudolph, Bryan is an individual health care provider with primary practice located at 3411 Wayne Ave 7Th Floor, Bronx NY 10467-2403. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Rudolph, Bryan can be contacted via phone (718) 741-2332.

Contact Information

Primary practice address
3411 Wayne Ave 7Th Floor Bronx NY 10467-2403
Phone: (718) 741-2332
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 257025-1 New York
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 257025 New York

Profile Details

NPI number 1811216948
LBN Legal business name Rudolph, Bryan
Credentials MD, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2010
Last updated May 11th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811216948 NPPES
New York MEDICAID 03363848

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