Provider Demographics
NPI:1942265673
Name:ROLINCIK, PAUL G III (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:G
Last Name:ROLINCIK
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 CHAPEL STREET
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-762-5858
Mailing Address - Fax:781-762-9402
Practice Address - Street 1:95 CHAPEL STREET
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-762-5858
Practice Address - Fax:781-762-9402
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73772174400000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3102262Medicaid
MAF29198Medicare UPIN
MAJ12623Medicare PIN