Healthcare Provider Details

I. General information

NPI: 1275931362
Provider Name (Legal Business Name): DEBORAH ANN ROFFI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 CORDING ROAD
YORKTOWN NY
10598
US

IV. Provider business mailing address

420 CORDING ROAD
YORKTOWN NY
10598
US

V. Phone/Fax

Practice location:
  • Phone: 914-588-0169
  • Fax:
Mailing address:
  • Phone: 914-588-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number281326-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: