MEDICARE: YVONNE ROSEMARIE RODNEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1598383762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE ROSEMARIE RODNEY

Provider Business Mailing Address
First Line	:	1275 E 51ST ST APT 7J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2231
Country	:	US
Telephone Number	:	718-241-4672
Fax Number	:

Provider Business Practice Location Address
First Line	:	1623 UTICA AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-1524
Country	:	US
Telephone Number	:	718-258-2716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	07/13/2020

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