Provider Demographics
NPI:1902438229
Name:MOJICA, RODRIGO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:
Last Name:MOJICA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 N WAGNER AVE
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2030
Mailing Address - Country:US
Mailing Address - Phone:646-732-4609
Mailing Address - Fax:
Practice Address - Street 1:1825 EASTCHESTER ROAD
Practice Address - Street 2:MONTEFIORE REHABILITATION DEPT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2301
Practice Address - Country:US
Practice Address - Phone:718-904-2785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist