Organization
DR JUAN DE ROSAS PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN F DE ROSAS MD (PRESIDENT OWNER)
(716) 434-8802
Entity
Organization
Contact information
Practice address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 434-8802
(716) 434-0093
Mailing address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 434-8802
(716) 434-0093
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
117428-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00506331001
BCBS
NY
05
—
00616317
—
NY
01
—
1901248
INDEPENDENT HEALTH
NY
Enumeration date
07/12/2005
Last updated
10/23/2007
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