Individual
WILLIAM RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 W 111TH ST, NEW YORK, NY 10026-4207
(212) 678-4990
(212) 665-1798
Mailing address
121 W 111TH ST, NEW YORK, NY 10026-4207
(212) 678-4990
(212) 665-1798
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
31142
NY
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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