Healthcare Provider Details

I. General information

NPI: 1952527582
Provider Name (Legal Business Name): ESTRELLA ROFFE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE RM 1D7
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

1901 1ST AVE RM 1D7
NEW YORK NY
10029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 646-672-3558
  • Fax: 646-672-3560
Mailing address:
  • Phone: 646-672-3558
  • Fax: 646-672-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number271244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: