Provider Demographics
NPI:1437049269
Name:RODRIGUEZ, SHUANG
Entity type:Individual
Prefix:
First Name:SHUANG
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9737 63RD RD APT 6E
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1621
Mailing Address - Country:US
Mailing Address - Phone:929-300-1208
Mailing Address - Fax:
Practice Address - Street 1:9737 63RD RD APT 6E
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1621
Practice Address - Country:US
Practice Address - Phone:929-300-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator