Basic Information
| Provider Information | |||||||||
| NPI: | 1154692515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA TUYAMA | ||||||||
| FirstName: | RODRIGO | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | TUYAMA | ||||||||
| OtherFirstName: | RODRIGO | ||||||||
| OtherMiddleName: | GARCIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2700 WESTCHESTER AVE | ||||||||
| Address2: | WESTMED MEDICAL GROUP | ||||||||
| City: | PURCHASE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105772547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146075730 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 55 HOLLY HILL LN STE 130 | ||||||||
| Address2: | |||||||||
| City: | GREENWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068306074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032102880 | ||||||||
| FaxNumber: | 2032102881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2012 | ||||||||
| LastUpdateDate: | 06/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 48949 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 291081 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 050949 | CT | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 48949 | KY | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 050949 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1154692515 | 05 | CT | MEDICAID |