Provider Demographics
NPI:1992943252
Name:DELA SERNA, ROLAND VANO (DPT)
Entity type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:VANO
Last Name:DELA SERNA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1359
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-0308
Mailing Address - Country:US
Mailing Address - Phone:631-646-2256
Mailing Address - Fax:631-249-1793
Practice Address - Street 1:740 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2212
Practice Address - Country:US
Practice Address - Phone:631-646-2256
Practice Address - Fax:631-249-1793
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY024079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist