Doctor Name: | MAYRA JOSELYN RODRIGUEZ |
NPI Number: | 1033530753 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 26NJ00473100 |
Business Practice Address: | 7 Martindale Rd # 1 Clifton, NJ - 070131614 |
Business Phone Number: | 9736381107 |
Business Fax Number: | |
Mailing Address: | 7 Martindale Rd # 1, CLIFTON |
State: | NJ |
Postal Code: | 070131614 |
Phone Number: | 9736381107 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2013 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00473100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |