Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 258306 | NY |
Y | 208000000X | Pediatrician | 60258306 | NY |
N | 2080P0216X | Pediatric Rheumatologist | 258306 | NY |
NPI | 1821393174 |
---|---|
Provider Name | Dr. Rose Karanicolas |
First Address | Sunnyside, NY 11104 |
Second Address | Sunnyside, NY 11104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2011 |
Last Update Date | 07/10/2014 |