Individual
KEISHA-MAE NICOLE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(929) 227-8131
Mailing address
21 DAVENPORT AVE APT 3A, NEW ROCHELLE, NY 10805-3427
(929) 227-8131
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
734950
NY
363L00000X
Nurse Practitioner
Primary
351553
NY
Other
Enumeration date
03/03/2023
Last updated
09/19/2023
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