Healthcare Provider Details

I. General information

NPI: 1053135293
Provider Name (Legal Business Name): ORLI ROFEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 HEMPSTEAD TPKE
EAST MEADOW NY
11554-2035
US

IV. Provider business mailing address

2310 HEMPSTEAD TPKE
EAST MEADOW NY
11554-2035
US

V. Phone/Fax

Practice location:
  • Phone: 516-346-5090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number032279-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: