Provider Demographics
NPI:1932505096
Name:RODNEY, MAGALIE
Entity Type:Individual
Prefix:
First Name:MAGALIE
Middle Name:
Last Name:RODNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9522 63RD RD
Mailing Address - Street 2:SUITE 157
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1142
Mailing Address - Country:US
Mailing Address - Phone:917-600-9305
Mailing Address - Fax:
Practice Address - Street 1:9522 63RD RD
Practice Address - Street 2:SUITE 157
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1142
Practice Address - Country:US
Practice Address - Phone:917-600-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY613060163WG0000X, 163WR0400X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation