Provider Demographics
NPI:1689896136
Name:HEIKE ROLLE-DAYA, MD
Entity Type:Organization
Organization Name:HEIKE ROLLE-DAYA, MD
Other - Org Name:DRS. ROLLE-DAYA & NAGPAUL
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-662-2100
Mailing Address - Street 1:3 WOODLAND ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1710
Mailing Address - Country:US
Mailing Address - Phone:781-662-2100
Mailing Address - Fax:781-662-7807
Practice Address - Street 1:3 WOODLAND ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1710
Practice Address - Country:US
Practice Address - Phone:781-662-2100
Practice Address - Fax:781-662-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2027321Medicaid
MA2035472Medicaid
MA1346231883OtherNPI - HEIKE ROLLE-DAYA
MA1780675231OtherNPI - KANTA NAGPAUL
MA2027321Medicaid
MAE03025Medicare UPIN