Provider Demographics
NPI:1043885122
Name:RODAS CEDENO, GABRIELA ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ALEJANDRA
Last Name:RODAS CEDENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-334-3000
Mailing Address - Fax:
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-3000
Practice Address - Fax:718-334-2862
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2024-03-18
Deactivation Date:2022-11-14
Deactivation Code:
Reactivation Date:2024-03-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program