Provider Demographics
NPI:1215317052
Name:RUDERMAN, EMMA KATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:KATHERINE
Last Name:RUDERMAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:42-09 28TH ST
Mailing Address - Street 2:EPIDEMIOLOGY DIVISION, BPHTID, 7-72
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:347-396-2846
Mailing Address - Fax:
Practice Address - Street 1:42-09 28TH ST
Practice Address - Street 2:EPIDEMIOLOGY DIVISION, BPHTID, 7-72
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4130
Practice Address - Country:US
Practice Address - Phone:347-396-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-07
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY293004207R00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine