Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 250414 | NY |
NPI | 1033377213 |
---|---|
Provider Name | Dr. Joseph J Rousso |
First Address | New York, NY 10010-7455 |
Second Address | Great Neck, NY 11021-4813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2008 |
Last Update Date | 22/10/2020 |