Provider Demographics
NPI:1164848149
Name:RODRIGUEZ, CINDY D
Entity Type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:D
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CINDY
Other - Middle Name:D
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922-0401
Mailing Address - Country:US
Mailing Address - Phone:845-480-4695
Mailing Address - Fax:
Practice Address - Street 1:2 2ND AVE APT 2B
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5242
Practice Address - Country:US
Practice Address - Phone:184-548-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3179431164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse