Provider Demographics
NPI:1821195405
Name:RODIL, MARIA ARLENE (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ARLENE
Last Name:RODIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:130W KINGSBRIDGE RD 9C-11B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-3904
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:718-741-4407
Practice Address - Street 1:1 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2545
Practice Address - Country:US
Practice Address - Phone:516-671-9800
Practice Address - Fax:516-671-9283
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2015-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY211580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01148961Medicaid
NY01148961Medicaid
NY0C6632Medicare ID - Type Unspecified