Individual
IVY DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
104 PHEASANT RUN, SUITE 123, NEWTOWN, PA 18940-3439
(215) 702-8600
Mailing address
104 PHEASANT RUN, STE 123, NEWTOWN, PA 18940-3413
(215) 702-8600
(215) 633-3480
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS015851
PA
Other
Enumeration date
06/14/2010
Last updated
07/19/2019
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