Provider Demographics
NPI:1538286190
Name:ROCKLAND NY MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:ROCKLAND NY MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTLYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-8800
Mailing Address - Street 1:20 SQUADRON BLVD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956
Mailing Address - Country:US
Mailing Address - Phone:845-634-8800
Mailing Address - Fax:
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:SUITE 550
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-634-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEU031Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER