Individual
MARLENE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3747 77TH ST, JACKSON HEIGHTS, NY 11372-6629
(718) 803-7300
Mailing address
37-47 77TH STREET, NEW YORK, NY 11372
(718) 803-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012252
NY
Other
Enumeration date
04/27/2010
Last updated
04/27/2010
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