Provider Information for 1164033296
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CATHERINE RODRIGUEZ MS
Sex: Female
NPI: 1164033296
Last Updated: 2024-09-13
Certification Date: 2024-09-13
Certification Date: 2024-09-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164033296 | ||||||||
| Enumeration Date | 2020-08-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 55 ROCKAWAY AVE VALLEY STREAM, NY 11580-5808 United States Phone: 845-614-3618 | Fax: | ||||||||
| Primary Practice Address | 55 ROCKAWAY AVE VALLEY STREAM, NY 11580-5808 United States Phone: 845-614-3618 | Fax: | ||||||||
| Secondary Practice Address(es) | 344 FULTON AVE | ||||||||
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