National Provider Identifier

Lauren Elizabeth Rudolph, MS, LAT, ATC

Lauren Elizabeth Rudolph, MS, LAT, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (774) 571-3884.

NPI 1497396089Ithaca, NYAthletic Trainer

Profile Overview

NPI
1497396089
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
October 04, 2019
Last Updated
August 09, 2024

Practice Location

  • 521 Campus RD
  • Ithaca, NY 14853-6007

Phone: (774) 571-3884

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1497396089
Entity Type
Individual
Last Name
Rudolph
First Name
Lauren
Middle Name
Elizabeth
Credential
MS, LAT, ATC
Mailing Street Address
521 Campus RD
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14853-6007
Mailing Country
US
Mailing Phone
(774) 571-3884
Practice Street Address
521 Campus RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14853-6007
Practice Country
US
Practice Phone
(774) 571-3884
Enumeration Date
October 04, 2019
Last Updated
August 09, 2024
Sex
Female
Sole Proprietor
No
Certification Date
August 09, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)