Provider Demographics
NPI:1588697494
Name:ROLITA, LYDIA (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:ROLITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:ROLITA
Other - Last Name:METELSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2943 KALAKAUA AVE APT 807
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4609
Mailing Address - Country:US
Mailing Address - Phone:347-541-5746
Mailing Address - Fax:
Practice Address - Street 1:95-390 KUAHELANI AVE
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1192
Practice Address - Country:US
Practice Address - Phone:808-627-3235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230195207QG0300X
HIMD19421207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine