MEDICARE: MARIA L RODRIGUES 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
1	208000000X	Pediatrics Physician	172606	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1730128570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA L RODRIGUES MD

Provider Business Mailing Address
First Line	:	55 WATER STREET
Second Line	:	2ND FLOOR CRED DEPT
City	:	NEW YORK
State	:	NY
Zip	:	10041-0004
Country	:	US
Telephone Number	:	646-680-2888
Fax Number	:	516-542-5556

Provider Business Practice Location Address
First Line	:	16959 137TH AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-4517
Country	:	US
Telephone Number	:	718-525-5600
Fax Number	:	718-559-5285

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	09/26/2019

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