Provider Demographics
NPI:1285707778
Name:RODRIGUEZ, ISABEL CARMEN (MD)
Entity type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:CARMEN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2527 GLEBE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3109
Mailing Address - Country:US
Mailing Address - Phone:718-904-7078
Mailing Address - Fax:718-904-7130
Practice Address - Street 1:2527 GLEBE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3109
Practice Address - Country:US
Practice Address - Phone:718-904-4415
Practice Address - Fax:718-931-7307
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY205766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01970543Medicaid
NY11V811Medicare PIN
NYG97592Medicare UPIN