Provider Demographics
NPI:1558411876
Name:RODRIGUEZ, MIGUELINA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MIGUELINA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:SOUTH BEACH PSYCHIATRIC CENTER 777 SEAVIEW AVENUE
Mailing Address - Street 2:BRIDGEVIEW 5A/B
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:646-552-7078
Mailing Address - Fax:718-667-2613
Practice Address - Street 1:SOUTH BEACH PSYCHIATRIC CENTER 777 SEAVIEW AVENUE
Practice Address - Street 2:BRIDGEVIEW 5A/B
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-667-2600
Practice Address - Fax:718-667-2613
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY014288-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014288N01OtherHIP OF NEW YORK
NYP2631180OtherOXFORD