Individual
CASEY ROLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1169 WANTAGH AVE, WANTAGH, NY 11793-2136
(516) 785-4800
(516) 785-4804
Mailing address
1169 WANTAGH AVE, WANTAGH, NY 11793-2217
(516) 785-4800
(516) 785-4804
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
039562-1
NY
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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