Provider Demographics
NPI:1184986002
Name:RODRIGUEZ, YANELA (TSLD)
Entity type:Individual
Prefix:
First Name:YANELA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:TSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 LUDDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3133
Mailing Address - Country:US
Mailing Address - Phone:973-557-5184
Mailing Address - Fax:
Practice Address - Street 1:259 LUDDINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011
Practice Address - Country:US
Practice Address - Phone:973-557-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist