David Rodriguez | Englewood, NJ • PECOS Search

David Rodriguez

Social Worker

Behavioral Health & Social Service Providers

93 W Palisade Ave, Englewood, NJ 07631-2611

(201) 567-0500 (201) 421-0515

PECOS Enrollment

Based on the most recent information from CMS, provider David 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 yesterday at 11:38 AM.

Profile Details

Provider ID
1194242453
Provider Type
Individual
Full Name
Rodriguez, David
Title
Mr.
Credential
LCSW

Gender
Male
Sole Proprietor
No
Enumeration Date
8/28/2017
Last Updated
6/16/2021

Contact Information

Practice Location

93 W Palisade Ave, Englewood, NJ 07631-2611

Unlisted Fax

Mailing Location

8325 Kennedy Blvd, Apt 3b, North Bergen, NJ 07047-4258

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 44SC05826000 New Jersey