Individual
MARISSA D RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 CLAREMONT AVE APT 1F, NEW YORK, NY 10027-4673
(559) 903-1953
Mailing address
150 CLAREMONT AVE APT 1F, NEW YORK, NY 10027-4673
(559) 903-1953
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
716767053
NY
2255A2300X
Athletic Trainer
Primary
F5340450
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WS72598A
—
NY
Enumeration date
05/05/2021
Last updated
05/05/2021
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