Provider Demographics
NPI:1316167331
Name:ROLLAN, SALVACION V (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:SALVACION
Middle Name:V
Last Name:ROLLAN
Suffix:
Gender:
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 KENNEDY BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-437-0250
Mailing Address - Fax:201-436-4191
Practice Address - Street 1:801 KENNEDY BOULEVARD
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:201-437-0250
Practice Address - Fax:201-436-4191
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019865-1225100000X
NJPT402A00949400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist