KENNETH H. RUDOLPH, M.D. (NPI# 1043498512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043498512 |
| Entity Type | Organization |
| Organization Name | KENNETH H. RUDOLPH, M.D. |
| Practice Address |
802 Jefferson Ave Scranton PA 18510-1038 |
| Practice Telephone | 5703433999 |
| Practice Fax Number | 5703432749 |
| Mailing Telephone | 5703433999 |
| Mailing Fax Number | 5703432749 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-06-09 |
| Authorized Official Name | KENNETH H RUDOLPH (OWNER) |
| Authorized Official Telephone | 5703433999 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
802 JEFFERSON AVE |
| City | SCRANTON |
| State | PA |
| Zip Code | 18510-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315085 | John E Prior | Internal Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2005-06-08 |
| 1730559881 | Jennifer Balinas | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2015-10-01 |
| 1578932414 | Michael Eugene Boyd | Nurse Practitioner | 802 Jefferson Ave, Mcauley Bldg 4th Fl, Scranton, PA 18510-1038 | 2015-09-22 |
| 1720461866 | Daniel Reese Shust | Family Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2015-07-07 |
| 1801927694 | Pulmonary and Critical Care Specialists of Pennsylvania PC | Internal Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2007-03-07 |
| 1164590071 | Alexa Lee Beretski | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-11-30 |
| 1265522015 | Susan Bennett | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-10-13 |
| 1831289693 | Amy Ferranti | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-10-13 |
| 1346269578 | American Home Care Supply Company, Inc. | Durable Medical Equipment & Medical Supplies | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-07-19 |
| 1568493088 | Ralf W Van Der Sluis | Specialist | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-07-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427432335 | Marla Osborne Dempsey | Family Medicine | 1141 Clay Ave Ste 1, Dunmore, PA 18510 | 2015-07-10 |
| 1669620043 | Mary Jane Miskovsky | Nurse Practitioner | 800 Linden Street, University of Scranton Student Health Service, Scranton, PA 18510 | 2008-08-28 |
| 1427174739 | Cheryl Friedman | Registered Nurse | 1710 Mulberry Street, Scranton, PA 18510 | 2007-03-21 |
| 1619092970 | Susan Rudalavage | Dietitian, Registered | 640 Madison Avenue, Scranton, PA 18510 | 2007-03-19 |
| 1851469738 | Lackawanna Surgery Center LLC | Clinic/Center | 415 Adams Avenue, Scranton, PA 18510 | 2006-12-01 |
| 1679666150 | Nicholas M. Rocco | Nurse Anesthetist, Certified Registered | 700 Quincy Ave., Scranton, PA 18510 | 2006-10-02 |
| 1710927587 | Care Plus Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Jefferson Ave, Scranton, PA 18510 | 2006-06-08 |
| 1619934189 | James M Haggerty | Podiatrist | 521 Ash Street, Dunmore, PA 18510 | 2006-04-28 |
| 1962461145 | Kevin G Madden | Psychiatry & Neurology | 802 Jefferson Avenue, Scranton, PA 18510 | 2006-03-17 |
| 1720058795 | Mark Trently | Nurse Anesthetist, Certified Registered | 1822 Jmulberry St, Scranton, PA 18510 | 2006-01-24 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862259 | Princy Kanakkumar Shah | Internal Medicine | Wright Medical Center, 501 S Washington Avenue, Scranton, PA 18505 | 2020-02-07 |
| 1801387394 | Talha Zain Tariq | Internal Medicine | 111 N Washington Ave., Scranton, PA 18503 | 2018-05-21 |
| 1467958025 | Hamza Hafeez | Internal Medicine | The Wright Center, 111 N. Washington Avenue, Suite 1, Scranton, PA 18503 | 2018-04-03 |
| 1346772027 | Nirali Pravinchandra Patel | Internal Medicine | 5 South Washington Ave, Suite 1000, Scranton, PA 18505 | 2017-03-31 |
| 1821538281 | Kristina Tanovic | Internal Medicine | 501 South Washington Ave, Suite 100 The Wright Center F, Scranton, PA 18505 | 2017-03-06 |
| 1982951711 | Chandrasekharreddy Navuluri | Internal Medicine | 403 Crestedge Mnr, Scranton, PA 18505-2379 | 2012-08-10 |
| 1740535004 | Deobrat Chandra Mallick | Internal Medicine | 205 Tall Trees Dr, Scranton, PA 18505-2239 | 2012-07-23 |
| 1205190055 | Sherine Tadros | Internal Medicine | 800 James Ave, Apt# 2222, Scranton, PA 18510-1551 | 2012-06-26 |
| 1528339439 | Edward Jan Zaloga | Internal Medicine | 1371 N Washington Ave, Scranton, PA 18509-2840 | 2012-01-24 |
| 1558631390 | Lekshminarayan Raghavakurup | Internal Medicine | 2000 Tall Trees Dr, 504 Tall Trees Apt, Scranton, PA 18505-2204 | 2012-01-11 |
| Find all providers in SCRANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.