Provider Demographics
NPI:1376801811
Name:ROLSTON, VINEET SYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VINEET
Middle Name:SYAN
Last Name:ROLSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VINEET
Other - Middle Name:
Other - Last Name:SYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:222 E 34TH ST
Mailing Address - Street 2:APT 909
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4842
Mailing Address - Country:US
Mailing Address - Phone:914-815-0921
Mailing Address - Fax:
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:914-815-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129245207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine