Provider Demographics
NPI:1427896117
Name:THOMAS-RUEDDEL, DANIEL OLIVER (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:OLIVER
Last Name:THOMAS-RUEDDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:OLIVER
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:251 W 92ND ST
Mailing Address - Street 2:APT. 11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7319
Mailing Address - Country:US
Mailing Address - Phone:646-656-2767
Mailing Address - Fax:718-920-4316
Practice Address - Street 1:111 E 210 STREET MONTEFIORE MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-4316
Practice Address - Fax:718-920-4316
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY332339207LC0200X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine