Wanda Victoria Rodriguez | Middletown, NY • PECOS Search

Wanda Victoria Rodriguez

Specialist

Other Service Providers

75 Crystal Run Rd Ste 201, Middletown, NY 10941-7010

(845) 692-4391 (212) 729-6482

PECOS Enrollment

Based on the most recent information from CMS, provider Wanda Victoria Rodriguez does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1750007621
Provider Type
Individual
Full Name
Rodriguez, Wanda Victoria
Title
Mrs.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/12/2022
Last Updated
10/12/2022

Contact Information

Practice Location

75 Crystal Run Rd Ste 201, Middletown, NY 10941-7010

Unlisted Fax

Mailing Location

12 Rebecca Dr, Middletown, NY 10940-8606

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer