Individual
STACEY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 365-6400
Mailing address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 365-6400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
92282
CT
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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