Individual
GIANKARLOS RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1410 DELSEA DR, DEPTFORD, NJ 08096-4101
(856) 579-8897
Mailing address
1410 DELSEA DR, DEPTFORD, NJ 08096-4101
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
MA067730
PA
363A00000X
Physician Assistant
Primary
25MP01045500
NJ
363A00000X
Physician Assistant
MA067730
PA
Other
Enumeration date
07/02/2026
Last updated
08/04/2026
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