Provider Demographics
NPI:1720135577
Name:RODRIGUES, CYNTHIA (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-1780
Practice Address - Fax:508-973-0359
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79700207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110058660AMedicaid
RICR22599Medicaid
RIU400237408Medicare PIN
MAS400114779Medicare PIN
RI401972OtherBLUECHIP OF RI
MAEX9523Medicare PIN
GA990004314OtherRAILROAD MEDICARE
MAA22685OtherMEDICARE OLD IDENTIFIER
RICR22599Medicaid
MAG49046Medicare UPIN
RI30345OtherNEIGHBORHOOD HEALTH PLAN
MA66431OtherHARVARD PILGRIM HEALTH
MA3168051Medicaid
RI293857OtherBLUE CROSS BLUE SHIELD