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Organization
GEORGE L. RODRIGUEZ, M.D., P.C.
Active
Organization
GEORGE L. RODRIGUEZ, M.D., P.C.
Active
Other names
Advanced Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN C. BAMBA (PRACTICE ADMINISTRATOR)
(215) 425-1500
Entity
Organization
Contact information
Practice address
1326 MACDADE BLVD, WOODLYN, PA 19094-1500
(215) 425-1500
(214) 525-1659
Mailing address
841 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2401
(215) 425-1500
(215) 425-1659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD 045274E
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD 036647E
PA
2085R0202X
Diagnostic Radiology Physician
131553-1 - NY
NY
2085R0202X
Diagnostic Radiology Physician
155494-1 - NY
NY
2085R0202X
Diagnostic Radiology Physician
MA076212
NJ
2085R0202X
Diagnostic Radiology Physician
MD 032938-E
PA
2085R0202X
Diagnostic Radiology Physician
MD 422104
PA
2085R0202X
Diagnostic Radiology Physician
MD 435786
PA
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0455759000
INDEPENDENCE BLUE CROSS
PA
01
—
626086
HIGHMARK BLUE SHIELD
—
Enumeration date
05/26/2009
Last updated
06/24/2009
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