Provider Demographics
NPI:1235699471
Name:RETUYA, ROLFE KEVIN CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLFE
Middle Name:KEVIN CHRISTIAN
Last Name:RETUYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 FULTON ST APT 810
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2093
Mailing Address - Country:US
Mailing Address - Phone:848-448-4581
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF MEDICINE HSC LEVEL 16, STONY BROOK HOSPITAL
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-2493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317857208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist