1215260005 NPI number — DR. MARION ROLLINGS PHD

Table of content: DR. MARION ROLLINGS PHD (NPI 1215260005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215260005 NPI number — DR. MARION ROLLINGS PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROLLINGS
Provider First Name:
MARION
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215260005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 NEW AMWELL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBOROUGH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08844-5516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-500-7295
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
236 W HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOUND BROOK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08805-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-500-7295
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP1600X , with the licence number:  4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0700X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC1900X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TM1800X , with the licence number: 4686 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)