Provider Demographics
NPI:1962891515
Name:ANN RODRIGUEZ NP PSYCHIATRY PC
Entity type:Organization
Organization Name:ANN RODRIGUEZ NP PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:914-450-6021
Mailing Address - Street 1:32 BROOK FARM RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1310
Mailing Address - Country:US
Mailing Address - Phone:914-450-6021
Mailing Address - Fax:845-728-0667
Practice Address - Street 1:1076 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3606
Practice Address - Country:US
Practice Address - Phone:914-450-6021
Practice Address - Fax:845-728-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400552-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty