DR. BRYAN RUDOLPH MD MPH NPI 1811216948

NPI Information

NPI: 1811216948
Provider Name: DR. BRYAN RUDOLPH, MD, MPH
Classification: Pediatrics - 2080P0206X
Entity Type: Individual

Specialization: Pediatric Gastroenterology

PECOS Registration: Yes

Address:
3411 WAYNE AVE
7TH FLOOR
BRONX, NY
ZIP 10467
Phone: (718) 741-2332
Get Directions

DR. Bryan Rudolph, MD, MPH is a pediatric gastroenterology pediatrics in Bronx, NY. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. DR. Bryan Rudolph, MD, MPH NPI is 1811216948. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3411 WAYNE AVE
7TH FLOOR
BRONX, NY
ZIP 10467-403
Phone: (718) 741-2332

The NPI 1811216948 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/28/2010 and was last updated on 5/11/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		257025-1	NEW YORK	No
2	2080P0206X	Pediatrics	Pediatric Gastroenterology	257025	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03363848	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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