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Individual

MS. MARY ANGELICA DAMIAN RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
008679
CT
225100000X
Physical Therapist
0307841
NY
225100000X
Physical Therapist
Primary
070017321
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0307841
PHYSICAL THERAPY NEW YORK LICENSE NUMBER
NY
Enumeration date
11/24/2009
Last updated
12/23/2009
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