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General NPI Number Information
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NPI Number | 1588697494
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Entity Type | Individual
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Provider Name | LYDIA ROLITA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 95-390 KUAHELANI AVE
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City | MILILANI
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State | HI
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Zip | 96789-1192
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Country | US
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Telephone | 808-627-3235
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Fax |
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Provider Business Mailing Address
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Address Line | 2943 KALAKAUA AVE APT 807
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City | HONOLULU
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State | HI
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Zip | 96815-4609
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Country | US
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Telephone | 347-541-5746
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Fax |
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 230195
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD19421
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License Number State | HI
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