Provider Demographics
NPI:1518530625
Name:RODRIGUEZ, CASIEL (FNP)
Entity Type:Individual
Prefix:
First Name:CASIEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RIVER RD APT S202
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1531
Mailing Address - Country:US
Mailing Address - Phone:347-847-9612
Mailing Address - Fax:
Practice Address - Street 1:395 FORT WASHINGTON AVE APT 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6728
Practice Address - Country:US
Practice Address - Phone:212-928-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347756-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily