Maria Krystle Glaze Favorito Roldan

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

307538 Issued in NY

Practice address

506 6TH St
Brooklyn, NY 11215-3609

Phone

(718) 780-3000

NPI assigned

Jun 8, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1316430820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 E 4TH ST APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097527",
            "telephone_number": "212-470-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "MARIA KRYSTLE GLAZE",
        "middle_name": "FAVORITO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Roland, LMSW
• Shanelle Roland
• Alexandra Roldan, LMHC
• Amadia Roldan
• Heather Roldan, M.ED, CAS MH
• Sandra Maria Roldan
• Rolex Medical Supplies Inc
• Courtney Rolf
• Adele Rolider
• Gemma Rolle, M.D.

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.