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General NPI Number Information
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NPI Number | 1770436818
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Entity Type | Individual
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Provider Name | JAIME ERNESTO RODRIGUEZ-NAZARIO CPS
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Gender | Male
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 200 EDISON RD
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City | ORANGE
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State | CT
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Zip | 06477-3602
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Country | US
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Telephone | 203-508-5784
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Fax |
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Provider Business Mailing Address
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Address Line | 1257 BARNUM AVE APT 1
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2843
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Country | US
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Telephone | 347-488-7403
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 25632
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License Number State | CT
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