Provider Demographics
NPI:1376285882
Name:RODNEY P. COE, M.D., P.L.L.C.
Entity Type:Organization
Organization Name:RODNEY P. COE, M.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE MEMBER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-757-4626
Mailing Address - Street 1:2391 BELL BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2019
Mailing Address - Country:US
Mailing Address - Phone:646-828-8660
Mailing Address - Fax:718-764-6296
Practice Address - Street 1:2391 BELL BLVD STE 204
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2019
Practice Address - Country:US
Practice Address - Phone:646-828-8660
Practice Address - Fax:718-764-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07216508Medicaid