Individual
DR. LEONEL A RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 PARK ST, NEW HAVEN, CT 06504-8901
(203) 785-4649
(203) 737-1384
Mailing address
333 CEDAR ST LMP# 4093, NEW HAVEN, CT 06510-3206
(203) 785-4649
(203) 737-1384
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
64286
CT
2080P0206X
Pediatric Gastroenterology Physician
Primary
64286
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029791
—
MA
01
—
468756
TUFTS HEALTH PLAN
MA
01
—
J27116
BCBS MA
MA
Enumeration date
11/08/2005
Last updated
09/30/2019
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