Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25MA06946700 | NJ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 25MA06946700 | NJ |
NPI | 1275579138 |
---|---|
Provider Name | David J Rodricks |
First Address | Brick, NJ 08724-7776 |
Second Address | Brick, NJ 08724-7776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 28/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86794 | (02) |