Healthcare Provider Details

I. General information

NPI: 1063511194
Provider Name (Legal Business Name): LOUIS RODRIGUES MD, MPH, FAAP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 BROADWAY
MONTICELLO NY
12701-1738
US

IV. Provider business mailing address

17 SUNSET DR
MONTICELLO NY
12701-4515
US

V. Phone/Fax

Practice location:
  • Phone: 845-796-2500
  • Fax: 845-796-2501
Mailing address:
  • Phone: 845-791-6708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number086006
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number086006
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: