Basic Information
| Provider Information | |||||||||
| NPI: | 1568500478 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROLAND J. FIGUEREDO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 E 72ND ST | ||||||||
| Address2: | 17 E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100214650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128612576 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30 W 138TH ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100371710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126907400 | ||||||||
| FaxNumber: | 2127406693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 06/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | FIGUEREDO | ||||||||
| AuthorizedOfficialFirstName: | ROLAND | ||||||||
| AuthorizedOfficialMiddleName: | JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | UNIT PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2126907400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 119118 | NY | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.