Provider Demographics
NPI:1477960458
Name:RODRIGUEZ, SUECHET (RN)
Entity Type:Individual
Prefix:
First Name:SUECHET
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 UNION TURNPIKE UNIT D1
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4057
Mailing Address - Country:US
Mailing Address - Phone:917-331-3959
Mailing Address - Fax:
Practice Address - Street 1:2475 CROTONA AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6487
Practice Address - Country:US
Practice Address - Phone:917-331-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR213163WC1500X
NY676321163WH0200X, 163WS0200X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool