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Individual
JOHN P ROSENBOOM
Active
Individual
JOHN P ROSENBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
068578
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068578
PHARMACY LICENSE
NY
Enumeration date
11/29/2021
Last updated
11/29/2021
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