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General NPI Number Information
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NPI Number | 1871709063
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Entity Type | Individual
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Provider Name | MARIO RODENAS MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 6 DEVINE ST STE 2B
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City | NORTH HAVEN
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State | CT
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Zip | 06473-2222
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Country | US
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Telephone | 203-287-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 6 DEVINE ST STE 2B
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City | NORTH HAVEN
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State | CT
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Zip | 06473-2222
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Country | US
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Telephone | 203-287-6200
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME126080
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License Number State | FL
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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 | ME126080
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045989
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 045989
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License Number State | CT
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