Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 50-056063 | NY |
NPI | 1063767267 |
---|---|
Provider Name | Dr. Sylwia Rostkowski |
First Address | Manhasset, NY 11030-3322 |
Second Address | Manhasset, NY 11030-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 13/07/2012 |