Individual
NINO ROLDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1132 SHELMIRE AVE, PHILADELPHIA, PA 19111-2763
(267) 401-3625
Mailing address
1132 SHELMIRE AVE, PHILADELPHIA, PA 19111-2763
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN632127
PA
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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