Individual
ALYSSA JADE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
14 BELLEMEADE AVE, SMITHTOWN, NY 11787-1857
(631) 265-5300
Mailing address
1118 NAMDAC AVE, BAY SHORE, NY 11706-6126
(631) 575-6859
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
325694
NY
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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