Shantae Rodriguez, PA | |
Stony Brook Medicine Em, 100 Nicolls Road, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 | |
(631) 444-2478 | |
(631) 444-3919 |
Full Name | Shantae Rodriguez |
---|---|
Gender | Female |
Speciality | Physician Assistant |
Location | Stony Brook Medicine Em, Stony Brook, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902055650 | NPI | - | NPPES |
012566 | Other | NY | LICENSE # |
1079871 | Other | NCCPA CERT.# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 012566 (New York) | Secondary |
363A00000X | Physician Assistant | 012566 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
Shantae Rodriguez, PA Po Box 1554, Stony Brook, NY 11790-0988 Ph: (631) 444-2478 | Shantae Rodriguez, PA Stony Brook Medicine Em, 100 Nicolls Road, Hsc, Level 4, Room 080, Stony Brook, NY 11794-8350 Ph: (631) 444-2478 |