Healthcare Provider Details

I. General information

NPI: 1497736920
Provider Name (Legal Business Name): ZOE RODRIGUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E BIMC DEPT OF OB GYN
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

150 E 42ND ST FL 10
NEW YORK NY
10017-5626
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2857
  • Fax:
Mailing address:
  • Phone: 212-420-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number217305
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: