Healthcare Provider Details

I. General information

NPI: 1952488231
Provider Name (Legal Business Name): FLORENCE ROLSTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 HAMPTON RD
SOUTHAMPTON NY
11968-3004
US

IV. Provider business mailing address

45 RESEARCH WAY SUITE 105
EAST SETAUKET NY
11733-6401
US

V. Phone/Fax

Practice location:
  • Phone: 631-283-0918
  • Fax:
Mailing address:
  • Phone: 631-675-2125
  • Fax: 631-675-2624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number205121
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number205121
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number205121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: