MEDICARE: BRITTNI CHELSEA RODRIGUEZ OD

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	152W00000X	Optometrist	009045	NY

General Provider Information

NPI Number	:	1861047649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNI CHELSEA RODRIGUEZ OD

Provider Business Mailing Address
First Line	:	2204 FREDERICK DOUGLASS BLVD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-1172
Country	:	US
Telephone Number	:	732-379-2339
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 FREDERICK DOUGLASS BLVD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-1172
Country	:	US
Telephone Number	:	732-379-2339
Fax Number	:

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

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	08/07/2019

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