Provider Demographics
NPI:1639259195
Name:WRIGHT, RODNEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1825 EASTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2301
Mailing Address - Country:US
Mailing Address - Phone:718-904-2767
Mailing Address - Fax:718-904-2799
Practice Address - Street 1:MMG - CFCC
Practice Address - Street 2:1621 EASTCHESTER RD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8040
Practice Address - Fax:718-405-8044
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212464207VM0101X
CAG79179207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G40842Medicare UPIN