Provider Demographics
NPI:1386824696
Name:RODRIGUEZ-HIRSCH, MADELINE (MSN, APRN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:
Last Name:RODRIGUEZ-HIRSCH
Suffix:
Gender:F
Credentials:MSN, APRN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:968 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-2237
Mailing Address - Country:US
Mailing Address - Phone:201-224-8328
Mailing Address - Fax:201-224-2405
Practice Address - Street 1:968 RIVER RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-2237
Practice Address - Country:US
Practice Address - Phone:201-224-8328
Practice Address - Fax:201-224-2405
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07875300163WD0400X, 163WG0000X
NJ26NJ01228600363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NO07875300OtherLICENSE #