Provider Demographics
NPI:1467632307
Name:ROLLINS, CONCETTA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CONCETTA
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-1516
Mailing Address - Country:US
Mailing Address - Phone:914-592-0419
Mailing Address - Fax:914-592-0434
Practice Address - Street 1:333 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-1516
Practice Address - Country:US
Practice Address - Phone:914-592-0419
Practice Address - Fax:914-592-0434
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist