Provider Demographics
NPI:1477791382
Name:RODRIGUEZ, MARIA CHRISTINA (PT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CHRISTINA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:MONTAUK
Mailing Address - State:NY
Mailing Address - Zip Code:11954-0102
Mailing Address - Country:US
Mailing Address - Phone:631-965-2743
Mailing Address - Fax:
Practice Address - Street 1:400 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4901
Practice Address - Country:US
Practice Address - Phone:212-263-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025157225100000X
CA35065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist