Active NPI
Edna Violeta Rodriguez, M.D.
- Pediatrics Physician
- Corona, NY
National Provider Identifier
1811047657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 242231-1
- Practice address
- 3716 108TH St
Corona, NY 11368-2025 - Phone
- (718) 651-4000
- Fax
- (718) 476-2501
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 242231-1 | NY | Primary |
Addresses
Primary practice location
3716 108TH St
Corona, NY 11368-2025
Mailing address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242231-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308268800000",
"number": "1811047657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 SOUTHERN BLVD",
"city": "BRONX",
"state": "NY",
"postal_code": "104592417",
"telephone_number": "718-589-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 108TH ST",
"city": "CORONA",
"state": "NY",
"postal_code": "113682025",
"telephone_number": "718-651-4000",
"fax_number": "718-476-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "EDNA",
"middle_name": "VIOLETA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2011-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "242231-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.