Individual
JESSE LUIS RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2190
(516) 455-3699
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(516) 455-3699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
313120
NY
208M00000X
Hospitalist Physician
Primary
A203644
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2018
Last updated
09/10/2025
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