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Individual

GLADYS L RODRIGUEZ-MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
85 SAINT GEORGE RD, SPRINGFIELD, MA 01104-3333
(413) 732-2120
Mailing address
147 NORMAN ST, WEST SPRINGFIELD, MA 01089-5003
(413) 736-8329

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042622756
COMMONWEALTH CARE ALLIANCE
MA
01
12529
HEALTH NEW ENGLAND
01
1307576
MBHP
05
1307576
MA
01
71756
TUFTS
01
8443
BMC
MA
01
997303
NETWORK HEALTH
MA
Enumeration date
09/14/2012
Last updated
09/14/2012
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