Healthcare Provider Details

I. General information

NPI: 1063702728
Provider Name (Legal Business Name): THE RODIN COMPANY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2011
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 BEACH 141ST ST
NEPONSIT NY
11694-1249
US

IV. Provider business mailing address

PO BOX 920181
ARVERNE NY
11692-0181
US

V. Phone/Fax

Practice location:
  • Phone: 917-742-4089
  • Fax: 718-474-6655
Mailing address:
  • Phone: 917-742-4089
  • Fax: 718-474-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberSP 2791
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMFC 19118
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number005002-1
License Number StateNY

VIII. Authorized Official

Name: PROF. ALAN MARC RODIN
Title or Position: PRESIDENT
Credential: M.A., S.L.P., C.C.C.
Phone: 917-742-4089