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Individual
HOPE LENORE DEROSA
Active
Individual
HOPE LENORE DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0101471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000408386001
B SHIELD
—
05
—
02636675
—
NY
01
—
10091080
CDPH
NY
01
—
783860
MVP
NY
Enumeration date
08/23/2005
Last updated
03/01/2013
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