Provider Demographics
NPI:1629418322
Name:RODES, DEBORAH B (DO)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:RODES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ST. ANDREWS LANE
Mailing Address - Street 2:NSLIJ-GLEN COVE HOSPITAL
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-674-7631
Mailing Address - Fax:516-674-7639
Practice Address - Street 1:101 ST. ANDREWS LANE
Practice Address - Street 2:NSLIJ-GLEN COVE HOSPITAL
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-674-7631
Practice Address - Fax:516-674-7639
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program