Individual ProviderMarie Anjeliese RodriguezInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address20 York St, New Haven, CT 06510-3220(203) 688-4242(312) 864-6000PECOS EnrollmentBased on the most recent information from CMS, provider Marie Anjeliese Rodriguez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1003420977Provider TypeIndividualFull NameRodriguez, Marie AnjelieseGenderFemaleSole ProprietorNoEnumeration Date9/8/2020Last Updated5/16/2023Contact InformationPractice LocationPractice Address20 York St, New Haven, CT 06510-3220Phone(203) 688-4242FaxUnlisted FaxMailing LocationMailing Address1901 W Harrison St, Chicago, IL 60612-3714Phone(312) 864-6000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense73296ConnecticutCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense125076921Illinois