Provider Demographics
NPI:1922755818
Name:RODRIGUEZ, SAMANTHA (CLC, DOULA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CLC, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-3318
Mailing Address - Country:US
Mailing Address - Phone:917-749-1637
Mailing Address - Fax:
Practice Address - Street 1:232 CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-3318
Practice Address - Country:US
Practice Address - Phone:917-749-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula