Organization
TELEHEALTH ADULT HEALTH NURSE PRACTITIONER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIANCA NICOLE RODRIQUEZ NP (OWNER)
(516) 708-6364
Entity
Organization
Contact information
Practice address
432 N BROOKSIDE AVE, FREEPORT, NY 11520-1045
(516) 708-6364
Mailing address
432 N BROOKSIDE AVE, FREEPORT, NY 11520-1045
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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