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NPI Code Detail

MEDICARE: GABRIELLE RODRIGUEZ

MEDICARE:   GABRIELLE  RODRIGUEZ
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
1101YM0800XMental Health Counselor
2104100000XSocial Worker

General Provider Information

NPI Number : 1821547001
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELLE RODRIGUEZ
Provider Business Mailing Address
First Line : 1816 MAYFLOWER AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-4104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1816 MAYFLOWER AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-4104
Country : US
Telephone Number : 347-872-4945
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2016
Last Update Date : 08/23/2021

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Directions to “ GABRIELLE RODRIGUEZ ” Practice Location

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