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General NPI Number Information
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NPI Number | 1619033677
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Entity Type | Individual
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Provider Name | DENNY XAVIER RODRIGUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 170 W 233RD ST
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City | BRONX
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State | NY
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Zip | 10463-5639
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Country | US
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Telephone | 718-543-0700
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Fax | 718-543-0788
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Provider Business Mailing Address
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Address Line | 114 COLUMBIA AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-5901
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Country | US
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Telephone | 201-313-6867
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Fax | 973-779-3854
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 242152
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License Number State | NY
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