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Organization
LANSDOWNE PODIATRY
Active
Organization
LANSDOWNE PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE RENEE ROLLE D.P.M. (OWNER)
(571) 223-0424
Entity
Organization
Contact information
Practice address
44135 WOODRIDGE PKWY, SUITE 180, LEESBURG, VA 20176-1244
(571) 223-0424
(571) 223-0425
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-3113
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659741742
MEDICAL ASSISTANCE
VA
01
—
F094
MEDICARE
VA
Enumeration date
10/01/2015
Last updated
12/18/2015
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