Healthcare Provider Details

I. General information

NPI: 1740107572
Provider Name (Legal Business Name): ALDA ROLLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 RIGBY RD
LANCASTER MA
01523-1703
US

IV. Provider business mailing address

99 RIGBY RD
LANCASTER MA
01523-1703
US

V. Phone/Fax

Practice location:
  • Phone: 347-782-9448
  • Fax:
Mailing address:
  • Phone: 347-782-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN2311848
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: