Basic Information
Provider Information
NPI: 1861794083
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AROCHO RODRIGUEZ
FirstName: DORA
MiddleName: Y.
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5800 3RD AVE
Address2: MANAGED CARE DEPARTMENT
City: BROOKLYN
State: NY
PostalCode: 112203702
CountryCode: US
TelephoneNumber: 7186307824
FaxNumber: 7186307437
Practice Location
Address1: 514 49TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112202010
CountryCode: US
TelephoneNumber: 7184312600
FaxNumber: 7184375239
Other Information
ProviderEnumerationDate: 11/19/2010
LastUpdateDate: 10/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X018749NYY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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