| Doctor Name: | MAILYN RODRIGUEZ |
| NPI Number: | 1295099505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 25MP00285500 |
| Business Practice Address: | 201 Route 17 North 5th Floor Rutherford, NJ - 07070 |
| Business Phone Number: | 2014570044 |
| Business Fax Number: | 2014570049 |
| Mailing Address: | 201 Route 17 North, 5th Floor RUTHERFORD |
| State: | NJ |
| Postal Code: | 07070 |
| Phone Number: | 2014570044 |
| Fax Number: | 2014570049 |
| NPI Enumeration Date: | 07/02/2012 |
| NPI Last Update Date: | 07/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 25MP00285500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |