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NPI Code Detail

MEDICARE: DR. RENEE RODRIGUEZ-GOODEMOTE MD

MEDICARE:  DR. RENEE  RODRIGUEZ-GOODEMOTE  MD
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
1207Q00000XFamily Medicine Physician215957NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295761435
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEE RODRIGUEZ-GOODEMOTE MD
Provider Business Mailing Address
First Line : 24 HAMILTON ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-4226
Country : US
Telephone Number : 518-886-5600
Fax Number : 518-886-5805
Provider Business Practice Location Address
First Line : 24 HAMILTON ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-4226
Country : US
Telephone Number : 518-886-5600
Fax Number : 518-886-5805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/02/2014

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