Provider Demographics
NPI:1740021385
Name:ROYCE, ROSHAN MATHEW (RN)
Entity type:Individual
Prefix:MR
First Name:ROSHAN
Middle Name:MATHEW
Last Name:ROYCE
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Gender:M
Credentials:RN
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Mailing Address - Street 1:140 OLD ORANGEBURG RD
Mailing Address - Street 2:BUILDING 57/3RD FLOOR
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1157
Mailing Address - Country:US
Mailing Address - Phone:845-680-8301
Mailing Address - Fax:845-680-5511
Practice Address - Street 1:140 OLD ORANGEBURG RD
Practice Address - Street 2:BUILDING 57/3RD FLOOR
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962
Practice Address - Country:US
Practice Address - Phone:845-680-8301
Practice Address - Fax:845-680-5511
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
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Provider Licenses
StateLicense IDTaxonomies
NY625906163WP0809X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse