Provider Demographics
NPI:1700059466
Name:RODRIGUEZ, VALERIE ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:ANN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:134 LANDING MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1157
Mailing Address - Country:US
Mailing Address - Phone:631-724-8584
Mailing Address - Fax:631-724-8584
Practice Address - Street 1:134 LANDING MEADOW RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1157
Practice Address - Country:US
Practice Address - Phone:631-724-8584
Practice Address - Fax:631-724-8584
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist