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NPI Code Detail

MEDICARE: YADIEL RODRIGUEZ

MEDICARE: YADIEL 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
11041C0700XClinical Social Worker229212MA

General Provider Information

NPI Number : 1457135675
Entity Type Code : Individual
Provider Name (Legal Business Name) : YADIEL RODRIGUEZ
Provider Business Mailing Address
First Line : 1337 SUMNER AVE
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01118-1764
Country : US
Telephone Number : 413-629-8339
Fax Number :
Provider Business Practice Location Address
First Line : 800 DISTRICT AVE STE 520
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-5060
Country : US
Telephone Number : 615-823-3970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2023
Last Update Date : 08/08/2024

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Directions to “ YADIEL RODRIGUEZ ” Practice Location

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