Telehealth Adult Health Nurse Practitioner

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TELEHEALTH ADULT HEALTH NURSE PRACTITIONER

Practice address

432 N Brookside Ave
Freeport, NY 11520-1045

Phone

(516) 708-6364

NPI assigned

Jan 29, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bianca Nicole Rodriquez, NPNPI 1164010096

Title

Owner

Phone

(516) 708-6364

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bianca Nicole Rodriquez, NP

  • Adult Health Nurse Practitioner
  • Commack, NY
  • NPI 1164010096
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1043023419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 N BROOKSIDE AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 N BROOKSIDE AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201045",
            "telephone_number": "516-708-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELEHEALTH ADULT HEALTH NURSE PRACTITIONER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "RODRIQUEZ",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-708-6364",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Devon D Taylor, ATC
• Webster Taylor
• Thomas Pharmacy, Inc.
• Cassandra Thomas, LPN
• Lisa Thomas
• Jean Thompson, LPN
• Robin Tiso

• Primary Care Clinic/Center in Freeport, NY
• Providers in Freeport, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.