Provider Demographics
NPI:1881416949
Name:RODRIGUEZ, DENNYS D (NP)
Entity type:Individual
Prefix:MRS
First Name:DENNYS
Middle Name:D
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DENNYS
Other - Middle Name:D
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:458 LAFAYETTE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2832
Mailing Address - Country:US
Mailing Address - Phone:551-232-9448
Mailing Address - Fax:
Practice Address - Street 1:458 LAFAYETTE AVE APT 10
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2832
Practice Address - Country:US
Practice Address - Phone:551-232-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15150700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily