MEDICARE: CESAR E AYALA-RODRIGUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	258109	NY

General Provider Information

NPI Number	:	1104156728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR E AYALA-RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	86 SAINT FELIX ST FL 9
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3032
Country	:	US
Telephone Number	:	718-250-8692
Fax Number	:	347-851-8217

Provider Business Practice Location Address
First Line	:	86 SAINT FELIX ST FL 9
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3032
Country	:	US
Telephone Number	:	718-250-8692
Fax Number	:	347-851-8217

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	10/18/2022

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