Individual provider Active NPI

Glenda E Rodriguez, SP.ED

  • Specialist
  • Bronx, NY
National Provider Identifier
1467894063
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
468834101 Issued in NY
Practice address
626 Trinity Ave
Apt 2G
Bronx, NY 10455-3004
Phone
(347) 281-3001
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 468834101 NY Primary
Specialist 174400000X 391489101 NY
Specialist 174400000X 677803121 NY

Addresses

Primary practice location

626 Trinity Ave
Apt 2G
Bronx, NY 10455-3004

Mailing address

626 Trinity Ave
Apt 2G
Bronx, NY 10455-3004
Phone (347) 281-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
391489101NYMDSpecialist
468834101NYMDSpecialist
677803121NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1467894063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 TRINITY AVE",
            "address_2": "APT 2G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553004",
            "telephone_number": "347-281-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 TRINITY AVE",
            "address_2": "APT 2G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553004",
            "telephone_number": "347-281-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GLENDA",
        "middle_name": "E",
        "credential": "SP.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "468834101",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "391489101",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "677803121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.