Provider Demographics
NPI:1730128570
Name:RODRIGUES, MARIA L (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:16959 137TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-4517
Practice Address - Country:US
Practice Address - Phone:718-525-5600
Practice Address - Fax:718-559-5285
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY172606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01236759Medicaid
NY9255SFMedicare ID - Type Unspecified