Provider Demographics
NPI:1790320851
Name:RODRIGUEZ, ANA GRECIA
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:GRECIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 E 214TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2412
Mailing Address - Country:US
Mailing Address - Phone:718-823-3190
Mailing Address - Fax:781-676-7715
Practice Address - Street 1:1180 E 214TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2412
Practice Address - Country:US
Practice Address - Phone:718-823-3190
Practice Address - Fax:781-676-7715
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist