Organization
WISE MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALCIBIADES J RODRIGUEZ M.D. (PRESIDENT)
(718) 441-0519
Entity
Organization
Contact information
Practice address
8403 CUTHBERT RD, SUITE 1A, KEW GARDENS, NY 11415-2140
(718) 441-0519
(718) 441-0554
Mailing address
8403 CUTHBERT RD, SUITE 1A, KEW GARDENS, NY 11415-2140
(718) 441-0519
(718) 441-0554
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02689334
—
NY
01
—
86R361
EBCBSH
—
Enumeration date
12/23/2010
Last updated
12/23/2010
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