Provider Demographics
NPI:1194056267
Name:RODRIGO, NANCY EDITH (M D)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:EDITH
Last Name:RODRIGO
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 JOSLIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-4209
Mailing Address - Country:US
Mailing Address - Phone:315-894-8258
Mailing Address - Fax:
Practice Address - Street 1:473 JOSLIN HILL RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-4209
Practice Address - Country:US
Practice Address - Phone:315-894-8258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176541207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology