Provider Demographics
NPI:1710950167
Name:ROLLINS, MICHAEL ARLINGTON JR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARLINGTON
Last Name:ROLLINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3184 GRAND CONCOURSE
Mailing Address - Street 2:LD
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1007
Mailing Address - Country:US
Mailing Address - Phone:718-584-0555
Mailing Address - Fax:718-584-0793
Practice Address - Street 1:3184 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1007
Practice Address - Country:US
Practice Address - Phone:718-584-0555
Practice Address - Fax:718-584-0793
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY191736207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02002660Medicaid
NY02002660Medicaid
G78125Medicare UPIN