Provider Demographics
NPI:1588732143
Name:RODRIGUES, NILOUFER A (MD)
Entity type:Individual
Prefix:
First Name:NILOUFER
Middle Name:A
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WEBSTER AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1361
Mailing Address - Country:US
Mailing Address - Phone:845-454-1942
Mailing Address - Fax:845-452-4638
Practice Address - Street 1:1 WEBSTER AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1361
Practice Address - Country:US
Practice Address - Phone:845-454-1942
Practice Address - Fax:845-452-4638
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140693207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00913942Medicaid
NYB80604Medicare UPIN
NY00913942Medicaid