Provider Demographics
NPI:1932783404
Name:RODRIGUES, ISAIAS J
Entity Type:Individual
Prefix:DR
First Name:ISAIAS
Middle Name:J
Last Name:RODRIGUES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PONDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3229
Mailing Address - Country:US
Mailing Address - Phone:413-336-8211
Mailing Address - Fax:
Practice Address - Street 1:97 PONDVIEW DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3229
Practice Address - Country:US
Practice Address - Phone:413-336-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAND10013175F00000X
CA1247175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty