Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | X008264 | NY |
N | 111NN1001X | Nutrition | X008264 | NY |
NPI | 1356484299 |
---|---|
Provider Name | Dr. Elicia B Rosen-Fox |
First Address | Brooklyn, NY 11228-3429 |
Second Address | Brooklyn, NY 11228-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5898131 | GHI (01) | NY |
U89772 | (02) | NY |