Provider Demographics
NPI:1114901832
Name:RODRIGUEZ, DONNA H (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:H
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2832
Mailing Address - Country:US
Mailing Address - Phone:607-733-3235
Mailing Address - Fax:607-733-4086
Practice Address - Street 1:460 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2832
Practice Address - Country:US
Practice Address - Phone:607-733-3235
Practice Address - Fax:607-733-4086
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y6842OtherBCBS
NY350045306OtherMEDICARE RAILROAD
NYC076150OtherWORKERS COMP
U48918Medicare UPIN
NY350045306OtherMEDICARE RAILROAD