Healthcare Provider Details

I. General information

NPI: 1578479853
Provider Name (Legal Business Name): ROLISON NP IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 ROUTE 55 STE A
LAGRANGEVILLE NY
12540-5052
US

IV. Provider business mailing address

3 ANTLER CT
HOPEWELL JUNCTION NY
12533-3545
US

V. Phone/Fax

Practice location:
  • Phone: 845-319-9179
  • Fax:
Mailing address:
  • Phone: 914-799-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLY ROLISON
Title or Position: PROVIDER & OWNER
Credential: FNP-C, MSN
Phone: 914-799-2023