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NPI Code Detail

MEDICARE: RUTH ROLAND P.T.

MEDICARE: RUTH ROLAND P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist003161NY

General Provider Information

NPI Number : 1538230537
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH ROLAND P.T.
Provider Business Mailing Address
First Line : 389 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3044
Country : US
Telephone Number : 631-261-0444
Fax Number : 631-261-3112
Provider Business Practice Location Address
First Line : 389 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3044
Country : US
Telephone Number : 631-261-0444
Fax Number : 631-261-3112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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Directions to “ RUTH ROLAND P.T.” Practice Location

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