Provider Demographics
NPI:1508055427
Name:RODRIGUES, SANDRINA (NP)
Entity Type:Individual
Prefix:MS
First Name:SANDRINA
Middle Name:
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-2148
Mailing Address - Fax:978-466-2128
Practice Address - Street 1:50 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 214
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-534-6863
Practice Address - Fax:978-534-3417
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA263758363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110076979AOtherMASSHEALTH