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General NPI Number Information
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NPI Number | 1205119344
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Entity Type | Organization
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Legal Business Name | RODRIGUE JOSEPH MD PC
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 8759 171ST ST
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City | JAMAICA
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State | NY
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Zip | 11432-4554
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Country | US
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Telephone | 516-860-7613
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Fax |
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Provider Business Mailing Address
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Address Line | 8759 171ST ST
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City | JAMAICA
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State | NY
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Zip | 11432-4554
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Country | US
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Telephone | 516-860-7613
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RODRIGUE JOSEPH
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Credential | MD
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Telephone | 516-860-7613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 196098
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License Number State | NY
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