Healthcare Provider Details

I. General information

NPI: 1255727574
Provider Name (Legal Business Name): REBECCA M MARRERO ROLON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST RM ST-737C
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST RM ST-737C
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-6898
  • Fax:
Mailing address:
  • Phone: 212-746-6898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License Number304553
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number304553
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: