Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 60102753-01 | NY |
Y | 208600000X | Surgeon | 60102753-01 | NY |
NPI | 1013551506 |
---|---|
Provider Name | Dr. Rosa Maria Jimenez Rodriguez |
First Address | New York, NY 10065-6342 |
Second Address | New York, NY 10065-6306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2019 |
Last Update Date | 29/10/2019 |