Provider Demographics
NPI:1730403619
Name:RUDD, DENISE L (LAC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:L
Last Name:RUDD
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 BATTLE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 E BROAD ST APT A
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1800
Practice Address - Country:US
Practice Address - Phone:609-333-2821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-20
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00069200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist