Organization
GEORGE L. RODRIGUEZ, M.D., P.C.
Active
Other names
Injury Rehabilitation Centers of Pennsylvania
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN C BAMBA (PRACTICE ADMINISTRATOR)
(215) 425-1500
Entity
Organization
Contact information
Practice address
841 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2401
(215) 425-1500
(215) 425-1659
Mailing address
841 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2401
(215) 425-1500
(215) 425-1659
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
MD 036647E
PA
207R00000X
Internal Medicine Physician
MD 045274E
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD-025907
PA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD 036647E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0455759000
INDEPENDENCE BLUE CROSS
PA
01
—
626088
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/21/2008
Last updated
06/24/2009
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