Healthcare Provider Details

I. General information

NPI: 1366241135
Provider Name (Legal Business Name): ROLANDE CHERUBIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 SAINT JOHNS PL APT 4B
BROOKLYN NY
11233-4993
US

IV. Provider business mailing address

1658 SAINT JOHNS PL APT 4B
BROOKLYN NY
11233-4993
US

V. Phone/Fax

Practice location:
  • Phone: 347-534-5899
  • Fax:
Mailing address:
  • Phone: 347-534-5899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number800480
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: