Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 1769339 | NY |
NPI | 1225344849 |
---|---|
Provider Name | Ms. Sara Rooz |
First Address | Brooklyn, NY 11219-3212 |
Second Address | Brooklyn, NY 11219-3212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2010 |
Last Update Date | 19/08/2010 |