Provider Demographics
NPI:1548717309
Name:AYBAR RODRIGUEZ, CARMINA MARGARITA (MD)
Entity type:Individual
Prefix:
First Name:CARMINA
Middle Name:MARGARITA
Last Name:AYBAR RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 DEKALB AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-3906
Mailing Address - Country:US
Mailing Address - Phone:929-432-3488
Mailing Address - Fax:
Practice Address - Street 1:1610 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3906
Practice Address - Country:US
Practice Address - Phone:929-432-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP03023208D00000X
NY318335207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice