Provider Demographics
NPI:1154467199
Name:ROLLERI, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ROLLERI
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 1:9 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2816
Mailing Address - Country:US
Mailing Address - Phone:800-677-8233
Mailing Address - Fax:866-540-1697
Practice Address - Street 1:9 W FRONT ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2816
Practice Address - Country:US
Practice Address - Phone:800-677-8233
Practice Address - Fax:866-540-1697
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy