Rudolph Willis is a Specialist in Irvington, New Jersey. Rudolph Willis practices all healthcare services and medical treatments related to Specialist. The NPI Number for Rudolph Willis is 1104887819. The last update date is 2018-02-06.
Rudolph Willis's current location address is 12 Krotik Pl, Irvington, New Jersey. You can contact this provider via phone number 9733733000. The mailing address for Rudolph Willis is 12 Krotik Pl, Irvington, New Jersey. To know further, please read the information below!
Provider Profile Detail
Provider Name | Rudolph Willis |
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Address | 12 Krotik Pl, Irvington, New Jersey |
Phone Number | 9733733000 |
Fax Number | |
Sole Proprietor | N |
Credentials | MD |
NPI Number Detail
NPI Number | 1104887819 |
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Provider Enumeration Date | 2006-03-31 |
Last Updated Date | 2018-02-06 |
Provider Mailing Address Detail
Address | 12 Krotik Pl |
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City | Irvington |
State | New Jersey (NJ) |
Post Code | 71111708 |
Phone Number | 9733733000 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Specialist |
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Taxonomy | 174400000X |
Licence No | MA42750 |
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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887307 | NJ | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Rudolph Willis by the Centers for Medicare & Medicaid Services?
The Rudolph Willis has been assigned the NPI (National Provider Identifier) 1104887819. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Rudolph Willis's physical address?
The Rudolph Willis is physically located at 12 Krotik Pl, in the city of Irvington, NJ, with the postal code 71111708.
What is the Rudolph Willis's specialty and taxonomy code?
The Rudolph Willis's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Rudolph Willis receive its 1104887819 assignment from the Centers for Medicare & Medicaid Services?
The Rudolph Willis was assigned its 1104887819 by the Centers for Medicare & Medicaid Services on 2006-03-31.
When was the information related to Rudolph Willis most recently updated or refreshed?
The details pertaining to the Rudolph Willis, including its address, specialty, and other relevant information, were last updated or refreshed on 2018-02-06.