Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F301194 | NY |
NPI | 1013075332 |
---|---|
Provider Name | Ms. Anna Maria Rose |
First Address | Hopewell Junction, NY 12533-5246 |
Second Address | Bronx, NY 10461-1138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 30/03/2016 |