Provider Demographics
NPI:1376721514
Name:MARCHESE, ROLANDO (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:MARCHESE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RUTA 9 BUZON 3001 BO. BORINQUEN
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-242-5476
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO DE MAYAGUEZ CARRETERA # 2
Practice Address - Street 2:ASSMCA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-242-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8,1811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical