Provider Demographics
NPI:1770805335
Name:ROLAND, BRIAN D
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:ROLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2227
Mailing Address - Country:US
Mailing Address - Phone:518-289-0031
Mailing Address - Fax:
Practice Address - Street 1:282 GEORGETOWN CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5515
Practice Address - Country:US
Practice Address - Phone:518-364-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical