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NPI Code Detail

MEDICARE: SHEIDA KISSAIRIS RODRIGUEZ

MEDICARE: SHEIDA KISSAIRIS RODRIGUEZ
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY
2207VM0101XMaternal & Fetal Medicine PhysicianV7054TX

General Provider Information

NPI Number : 1245814839
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEIDA KISSAIRIS RODRIGUEZ
Provider Business Mailing Address
First Line : 1605 TOWNSEND AVE APT 5A
Second Line :
City : BRONX
State : NY
Zip : 10452-5907
Country : US
Telephone Number : 646-316-9014
Fax Number :
Provider Business Practice Location Address
First Line : 327 BEACH 19TH ST
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-4423
Country : US
Telephone Number : 646-316-9014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2021
Last Update Date : 05/01/2026

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Directions to “ SHEIDA KISSAIRIS RODRIGUEZ ” Practice Location

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