Rodriguez, Rafael Antonio

Rodriguez, Rafael Antonio is an sole proprietor health care provider with primary practice located at 3711 88Th St , Jackson Heights NY 11372-7630. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Rodriguez, Rafael Antonio can be contacted via phone (347) 605-2785.

Contact Information

Primary practice address
3711 88Th St Jackson Heights NY 11372-7630
Phone: (347) 605-2785
Fax: (347) 572-8781
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 179642 New York
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 179642 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 179642 New York

Profile Details

NPI number 1053536250
LBN Legal business name Rodriguez, Rafael Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 16th, 2007
Last updated Dec 12th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053536250 NPPES
New York MEDICAID 01618015

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