Individual
MINDI RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
722 W 168TH ST, NEW YORK, NY 10032-3727
(212) 305-2500
Mailing address
42 FAIRLAWN LN, CENTEREACH, NY 11720-2807
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
016938
NY
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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