Provider Demographics
NPI:1154692515
Name:GARCIA TUYAMA, RODRIGO (MD)
Entity type:Individual
Prefix:
First Name:RODRIGO
Middle Name:
Last Name:GARCIA TUYAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RODRIGO
Other - Middle Name:GARCIA
Other - Last Name:TUYAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 WESTCHESTER AVE
Mailing Address - Street 2:WESTMED MEDICAL GROUP
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-607-5730
Mailing Address - Fax:
Practice Address - Street 1:55 HOLLY HILL LN STE 130
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6074
Practice Address - Country:US
Practice Address - Phone:203-210-2880
Practice Address - Fax:203-210-2881
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48949207R00000X, 208M00000X
NY291081207R00000X
CT050949208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1154692515Medicaid