Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 280537 | NY |
NPI | 1497099857 |
---|---|
Provider Name | Dr. Renee Rolston |
First Address | New York, NY 10027-2838 |
Second Address | Bronx, NY 10461-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2012 |
Last Update Date | 06/05/2019 |