Provider Demographics
NPI:1447750187
Name:ORJI, ROLLAND
Entity Type:Individual
Prefix:
First Name:ROLLAND
Middle Name:
Last Name:ORJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131-28 229TH STREET
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1839
Mailing Address - Country:US
Mailing Address - Phone:347-264-1731
Mailing Address - Fax:
Practice Address - Street 1:131-28 229TH STREET
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1839
Practice Address - Country:US
Practice Address - Phone:347-264-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176648110172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver