Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 186041 | NY |
Y | 111NI0900X | Internist | 186041 | NY |
N | 207RH0000X | Hematologist | 25MA05615100 | NJ |
N | 207RX0202X | Medical Oncology | MA605615100 | NJ |
NPI | 1457388498 |
---|---|
Provider Name | Dr. T Rose |
First Address | Freehold, NJ 07728-9070 |
Second Address | Freehold, NJ 07728-9070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 06/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0044962 | (05) | NJ |
F84113 | (02) | NJ |