Provider Demographics
NPI:1659704609
Name:ROLON, SUJEY J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SUJEY
Middle Name:J
Last Name:ROLON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CALLE ALAMO
Mailing Address - Street 2:GRAND PALM II
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-9029
Mailing Address - Country:US
Mailing Address - Phone:787-447-1693
Mailing Address - Fax:
Practice Address - Street 1:7570 KMART PHARMACY DE DIEGO EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-795-5088
Practice Address - Fax:787-784-3290
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist