Healthcare Provider Details

I. General information

NPI: 1831151281
Provider Name (Legal Business Name): ALCIBIADES J. RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 E 34TH ST
NEW YORK NY
10016-4852
US

IV. Provider business mailing address

223 E 34TH ST
NEW YORK NY
10016-4852
US

V. Phone/Fax

Practice location:
  • Phone: 646-558-0800
  • Fax:
Mailing address:
  • Phone: 646-558-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number235967
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number235967
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number235967
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: