=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861545600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROHANA MOTLEY,MD,PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 137 W 96TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10025-6403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-965-5938
-----------------------------------------------------
Fax | 212-531-3868
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1366
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10026-0964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-964-5938
-----------------------------------------------------
Fax | 212-531-3868
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. R MOTLEY
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 347-452-1817
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 223555
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------