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General NPI Number Information
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NPI Number | 1093318883
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Entity Type | Individual
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Provider Name | DAMARIS ENID RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 6002 COTTAGE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19135-3617
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Country | US
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Telephone | 215-948-9893
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Fax |
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Provider Business Mailing Address
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Address Line | 6002 COTTAGE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19135-3617
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Country | US
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Telephone | 215-948-9893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 50303601
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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