| Ana M. Rodriguez-diaz, Md | |
|
1119 Broad St Newark NJ 07114-2501 | |
| (201) 926-6899 | |
| Not Available |
| Full Name | Ana M. Rodriguez-diaz, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 1119 Broad St, Newark, New Jersey |
| Authorized Official Name and Position | Ana M. Rodriguez-diaz (MANAGER) |
| Authorized Official Contact | 2019266899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ana M. Rodriguez-diaz, Md Po Box 5733 Newark NJ 07105-7733 Ph: (201) 926-6899 | Ana M. Rodriguez-diaz, Md 1119 Broad St Newark NJ 07114-2501 Ph: (201) 926-6899 |
| NPI Number | 1518056332 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2668401258 |
|---|---|
| Medicare Enrollment ID | O20050804000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518056332 | NPI | - | NPPES |
| 7269005 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA 064780 (New Jersey) | Primary |
| 207RI0200X | Internal Medicine - Infectious Disease | MA064780 (New Jersey) | Primary |
| Provider Name | Ana M Rodriguez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710104922 PECOS PAC ID: 5698719946 Enrollment ID: I20050616001069 |
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