Provider Demographics
NPI:1699832774
Name:RODRIGUEZ, RAMON ELIAS (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ELIAS
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1250 MARIGOLD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1722
Mailing Address - Country:US
Mailing Address - Phone:732-545-8259
Mailing Address - Fax:732-247-5574
Practice Address - Street 1:1250 MARIGOLD ST
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1722
Practice Address - Country:US
Practice Address - Phone:732-545-8259
Practice Address - Fax:732-247-5574
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA07268208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH57907Medicare UPIN