Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F309050 | NY |
NPI | 1023675378 |
---|---|
Provider Name | Mrs. Audrey Lynne Rosales Train |
First Address | New York, NY 10023-7103 |
Second Address | New York, NY 10023-7103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2019 |
Last Update Date | 22/05/2019 |