Doctor Name: | BRAULIO ROLLAN |
NPI Number: | 1427227800 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25MA03620100 |
Business Practice Address: | 6 Deerfield Rd Livingston, NJ - 070392202 |
Business Phone Number: | 9739944621 |
Business Fax Number: | 9738570321 |
Mailing Address: | 6 Deerfield Rd, LIVINGSTON |
State: | NJ |
Postal Code: | 070392202 |
Phone Number: | 9739944621 |
Fax Number: | 9738570321 |
NPI Enumeration Date: | 02/29/2008 |
NPI Last Update Date: | 02/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA03620100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |