Provider Demographics
NPI:1174149694
Name:RODRIGUEZ, JOSEPH MANUEL (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MANUEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 1ST AVE # 2A31
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7494
Mailing Address - Country:US
Mailing Address - Phone:212-423-6684
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE # 2A31
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7494
Practice Address - Country:US
Practice Address - Phone:212-423-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324605207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine