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NPI Code Detail

MEDICARE: ISIS LILY RODRIGUEZ

MEDICARE: ISIS LILY 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 Program

General Provider Information

NPI Number : 1366394066
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISIS LILY RODRIGUEZ
Provider Business Mailing Address
First Line : 20 HERITAGE PL S
Second Line :
City : NESCONSET
State : NY
Zip : 11767-1941
Country : US
Telephone Number : 631-416-8455
Fax Number :
Provider Business Practice Location Address
First Line : 790 PARK AVE
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-4516
Country : US
Telephone Number : 631-427-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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Directions to “ ISIS LILY RODRIGUEZ ” Practice Location

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