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General NPI Number Information
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NPI Number | 1306662978
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Entity Type | Individual
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Provider Name | ESMERLYN RODRIGUEZ RDH
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Gender | Female
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Dates
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Enumeration Date | 11/28/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 242 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-2505
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Country | US
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Telephone | 973-955-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 310 N 11TH ST
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City | PROSPECT PARK
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State | NJ
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Zip | 07508-2102
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Country | US
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Telephone | 973-930-2937
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 22H101271200
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License Number State | NJ
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