Healthcare Provider Details

I. General information

NPI: 1588340921
Provider Name (Legal Business Name): MONSERRAT RODRIGUEZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD COUNTRY RD STE C103N
WESTBURY NY
11590-5156
US

IV. Provider business mailing address

78 LEXINGTON DR
NEWBURGH NY
12550-1294
US

V. Phone/Fax

Practice location:
  • Phone: 516-806-6969
  • Fax:
Mailing address:
  • Phone: 929-364-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: