| Doctor Name: | MRS. THERESA RODINO |
| NPI Number: | 1699013540 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 26NJ00449900 |
| Business Practice Address: | 2576 Ridge Ave Egg Harbor Twp, NJ - 082345552 |
| Business Phone Number: | 6093652163 |
| Business Fax Number: | |
| Mailing Address: | 2576 Ridge Ave, EGG HARBOR TWP |
| State: | NJ |
| Postal Code: | 082345552 |
| Phone Number: | 6093652163 |
| Fax Number: | |
| NPI Enumeration Date: | 01/28/2013 |
| NPI Last Update Date: | 08/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 26NJ00449900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |