Individual
ROLANDO HUMBERTO VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3615 CHESTNUT ST, PHILADELPHIA, PA 19104-2612
(215) 662-2746
Mailing address
22 VICTORY WAY, UPPER CHICHESTER, PA 19061-2470
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
SP026270
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP026270
PA
Other
Enumeration date
09/15/2022
Last updated
11/14/2022
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