Provider Demographics
NPI:1295578482
Name:GIRON, RODOLFO
Entity type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:GIRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 HARRISON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5923
Mailing Address - Country:US
Mailing Address - Phone:732-693-7103
Mailing Address - Fax:
Practice Address - Street 1:1 NORMAL AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1624
Practice Address - Country:US
Practice Address - Phone:732-693-7103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer