Provider Demographics
NPI:1376721555
Name:RODRIGUES, ELIZABETH MARIA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIA
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-2607
Mailing Address - Country:US
Mailing Address - Phone:908-352-6595
Mailing Address - Fax:908-354-2033
Practice Address - Street 1:34 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-2607
Practice Address - Country:US
Practice Address - Phone:908-352-6595
Practice Address - Fax:908-354-2033
Is Sole Proprietor?:No
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI22276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJRI22276OtherRPH STATE LICENSE