| Rolando R.roman Mdpc | |
|
8854 180th St Jamaica NY 11432-4738 | |
| (718) 657-8306 | |
| Not Available |
| Full Name | Rolando R.roman Mdpc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8854 180th St, Jamaica, New York |
| Authorized Official Name and Position | Rolando Ronquillo Roman (PRESIDENT) |
| Authorized Official Contact | 7186578306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rolando R.roman Mdpc 8854 180th St Jamaica NY 11432-4738 Ph: (718) 657-8306 | Rolando R.roman Mdpc 8854 180th St Jamaica NY 11432-4738 Ph: (718) 657-8306 |
| NPI Number | 1891091757 |
|---|---|
| Provider Enumeration Date | 02/09/2011 |
| Last Update Date | 02/09/2011 |
| Medicare PECOS PAC ID | 0143401687 |
|---|---|
| Medicare Enrollment ID | O20110216001106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891091757 | NPI | - | NPPES |
| 01427090 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 185214 (New York) | Primary |
| Provider Name | Rolando R Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659345049 PECOS PAC ID: 4587845037 Enrollment ID: I20110216001150 |
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