Provider Demographics
NPI:1821978701
Name:PAULINO RODRIGUEZ, MARIEL D
Entity type:Individual
Prefix:
First Name:MARIEL
Middle Name:D
Last Name:PAULINO RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 FOWLER AVE BSMT
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4044
Mailing Address - Country:US
Mailing Address - Phone:347-257-7829
Mailing Address - Fax:
Practice Address - Street 1:1710 FOWLER AVE BSMT
Practice Address - Street 2:BSMT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4044
Practice Address - Country:US
Practice Address - Phone:347-257-7829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY750271-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse