Provider Demographics
NPI:1487807897
Name:PABON-RODRIGUEZ, TENILLE
Entity type:Individual
Prefix:MRS
First Name:TENILLE
Middle Name:
Last Name:PABON-RODRIGUEZ
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 1:8 MCDOUGAL LN
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-7437
Mailing Address - Country:US
Mailing Address - Phone:917-291-3743
Mailing Address - Fax:
Practice Address - Street 1:8 MCDOUGAL LN
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-7437
Practice Address - Country:US
Practice Address - Phone:917-291-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017540-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist