Provider Demographics
NPI:1154022218
Name:RODRIGUEZ, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:RODRIGUEZ HIDALGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22510 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2615
Mailing Address - Country:US
Mailing Address - Phone:917-741-6141
Mailing Address - Fax:
Practice Address - Street 1:22510 88TH AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2615
Practice Address - Country:US
Practice Address - Phone:917-741-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency