Individual
DR. QUILVIO ANTONIO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC, RN
Contact information
Practice address
154 W 127TH ST, NEW YORK, NY 10027-3739
(212) 749-3507
Mailing address
4419 3RD AVE, BRONX, NY 10457-2562
(718) 364-7700
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
703575
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403045-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
703575
—
NY
Enumeration date
05/14/2020
Last updated
01/13/2022
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