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General NPI Number Information
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NPI Number | 1295528883
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Entity Type | Individual
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Provider Name | MIKA M. ROCKHOLT MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 550 1ST AVE DEPT OF
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 646-209-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 530 W 30TH ST APT 15E
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City | NEW YORK
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State | NY
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Zip | 10001-1443
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Country | US
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Telephone | 646-209-7590
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Fax | 646-209-7590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 337160
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License Number State | NY
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