Provider Demographics
NPI:1376334789
Name:DONGUYA, RODEL SOMIDO (RN)
Entity type:Individual
Prefix:MR
First Name:RODEL
Middle Name:SOMIDO
Last Name:DONGUYA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CORBIN CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7444
Mailing Address - Country:US
Mailing Address - Phone:732-581-4511
Mailing Address - Fax:
Practice Address - Street 1:16 WHITESVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4105
Practice Address - Country:US
Practice Address - Phone:732-797-2505
Practice Address - Fax:732-797-2506
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR24028700163WP0200X, 163WA0400X
NY809002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse