Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 320094 | NY |
NPI | 1801323365 |
---|---|
Provider Name | Stacey Hope Rosman |
First Address | Binghamton, NY 13905 |
Second Address | Vestal, NY 13850-3556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2017 |
Last Update Date | 18/05/2021 |