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General NPI Number Information
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NPI Number | 1205797107
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Entity Type | Individual
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Provider Name | GABRIEL FONDEUR RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 325 AUDUBON AVE
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City | NEW YORK
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State | NY
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Zip | 10033-4245
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Country | US
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Telephone | 212-281-9472
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Fax |
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Provider Business Mailing Address
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Address Line | 507 E 31ST ST FL 1
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City | PATERSON
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State | NJ
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Zip | 07504-2121
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 358413
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License Number State | NY
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