Provider Demographics
NPI:1457540056
Name:ROLAND NYEIN MD PC
Entity Type:Organization
Organization Name:ROLAND NYEIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:NYEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-226-5530
Mailing Address - Street 1:68 BAYARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4941
Mailing Address - Country:US
Mailing Address - Phone:212-226-5530
Mailing Address - Fax:212-343-9682
Practice Address - Street 1:68 BAYARD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4941
Practice Address - Country:US
Practice Address - Phone:212-226-5530
Practice Address - Fax:212-343-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214920207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02176121Medicaid
H46590Medicare UPIN