Provider Demographics
NPI:1487891743
Name:RODAS, CLAUDIA FERNANDA (PT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:FERNANDA
Last Name:RODAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 RIVER RD APT 9H
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1464
Mailing Address - Country:US
Mailing Address - Phone:201-658-7842
Mailing Address - Fax:
Practice Address - Street 1:1434 LONGFELLOW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1604
Practice Address - Country:US
Practice Address - Phone:718-589-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist