Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 153790 | NY |
N | 207XS0106X | Orthopaedic Hand Surgeon | 153790 | NY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 153790 | NY |
NPI | 1285748541 |
---|---|
Provider Name | Dr. Louis Charles Rose |
First Address | New York, NY 10021-3173 |
Second Address | Bronx, NY 10461-5726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 25/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01088820 | (05) | NY |
A60523 | (02) | NY |