Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | MD022419E | PA |
N | 207VX0000X | Obstetrician | MD022419E | PA |
NPI | 1003866815 |
---|---|
Provider Name | Dr. Daniel P Rollo |
First Address | Lebanon, PA 17046-4871 |
Second Address | Lebanon, PA 17046-4871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00807560 | (05) | PA |
C31195 | (02) |