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General NPI Number Information
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NPI Number | 1558579201
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Entity Type | Organization
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Legal Business Name | WAKEFIELD MEDICAL PROFESSIONALS, P.C.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 711 NEREID AVE
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City | BRONX
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State | NY
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Zip | 10466-1201
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Country | US
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Telephone | 718-994-6755
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Fax | 718-994-3032
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Provider Business Mailing Address
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Address Line | 711 NEREID AVE
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City | BRONX
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State | NY
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Zip | 10466-1201
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Country | US
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Telephone | 718-994-6755
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Fax | 718-994-3032
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RODOLFO COMUYOG UY
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Credential | M.D.
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Telephone | 718-994-6755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 236741
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 202436
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 166745
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 170475
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 218147
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 169367
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 237144
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License Number State | NY
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