Individual
MR. MICHAEL JOSEPH DEROSA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
423 E 23RD ST, NEW YORK, NY 10010-5011
(212) 686-7500
(212) 951-5444
Mailing address
6260 82ND ST, MIDDLE VILLAGE, NY 11379-1427
(212) 686-7500
(212) 951-5444
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
30 303835
NY
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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