Individual
JUAN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-6204
Mailing address
306 1ST ST, APT.2, WESTFIELD, NJ 07090-3318
(732) 423-1011
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14136100
NJ
163WE0003X
Emergency Registered Nurse
619839-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F307550-1
NY
Other
Enumeration date
10/05/2015
Last updated
02/10/2016
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