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General NPI Number Information
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NPI Number | 1376334789
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Entity Type | Individual
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Provider Name | RODEL SOMIDO DONGUYA RN
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Gender | Male
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 16 WHITESVILLE RD STE A
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City | TOMS RIVER
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State | NJ
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Zip | 08753-4105
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Country | US
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Telephone | 732-797-2505
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Fax | 732-797-2506
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Provider Business Mailing Address
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Address Line | 350 CORBIN CT
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City | LAKEWOOD
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State | NJ
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Zip | 08701-7444
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Country | US
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Telephone | 732-581-4511
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 26NR24028700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 26NR24028700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 809002
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License Number State | NY
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