Provider Demographics
NPI:1083372312
Name:ROLLINS, NASANDI NEQUANDI
Entity Type:Individual
Prefix:
First Name:NASANDI
Middle Name:NEQUANDI
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2705
Mailing Address - Country:US
Mailing Address - Phone:732-983-1835
Mailing Address - Fax:
Practice Address - Street 1:73 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2705
Practice Address - Country:US
Practice Address - Phone:732-983-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities