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General NPI Number Information
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NPI Number | 1861058638
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Entity Type | Individual
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Provider Name | DIANE RODRIGUEZ LICENSED PHLEBOTOMIS
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Gender | Female
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 290 MOUNTAUK HWY. UNIT #286
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City | MORICHES
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State | NY
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Zip | 11955
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Country | US
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Telephone | 631-800-6441
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Fax | 631-503-7826
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Provider Business Mailing Address
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Address Line | 290 MOUNTAUK HWY. UNIT #286
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City | MORICHES
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State | NY
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Zip | 11955
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Country | US
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Telephone | 631-800-6441
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Fax | 631-503-7826
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number | 81F992
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License Number State | NY
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