Individual
GWENDOLYN RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRANIAL PROSTHETIC
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
1204017518
VA
332BC3200X
Customized Equipment (DME)
22RO00331168
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720185762
—
VA
Enumeration date
11/27/2017
Last updated
03/17/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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