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NPI Code Detail

MEDICARE: SALLY ROLDAN

MEDICARE:   SALLY  ROLDAN
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
1174400000XSpecialist

General Provider Information

NPI Number : 1578413662
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY ROLDAN
Provider Business Mailing Address
First Line : 37 W 20TH ST STE 909
Second Line :
City : NEW YORK
State : NY
Zip : 10011-3715
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 37 W 20TH ST STE 909
Second Line :
City : NEW YORK
State : NY
Zip : 10011-3715
Country : US
Telephone Number : 212-362-7010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ SALLY ROLDAN ” Practice Location

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