MEDICARE: GIORNANDA 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
1	106S00000X	Behavior Technician
2	171M00000X	Case Manager/Care Coordinator		NY

General Provider Information

NPI Number	:	1881175123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIORNANDA RODRIGUEZ

Provider Business Mailing Address
First Line	:	442 W 160TH ST APT 6C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-6337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 W 160TH ST APT 6C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-6337
Country	:	US
Telephone Number	:	917-564-7156
Fax Number	:

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

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	12/09/2024

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Directions to “ GIORNANDA RODRIGUEZ ” Practice Location

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