Provider Demographics
NPI:1861092652
Name:RODRIGUEZ, FRANGELY JINELLE-MARIE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:FRANGELY
Middle Name:JINELLE-MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1564
Mailing Address - Country:US
Mailing Address - Phone:973-288-4161
Mailing Address - Fax:
Practice Address - Street 1:10 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2507
Practice Address - Country:US
Practice Address - Phone:973-288-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00844200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist