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Individual

RANDOLPH ROSARION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12010 15TH AVE, RM. 6, COLLEGE POINT, NY 11356-1617
(718) 701-5949
(718) 701-5949
Mailing address
12010 15TH AVE, RM. 6, COLLEGE POINT, NY 11356-1617
(718) 701-5949
(718) 701-5949

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
201787
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
201787
NY
208VP0000X
Pain Medicine Physician
201787
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01215142
AMERIGROUP
NY
05
01902914
NY
01
11303
MAGNACARE
NY
01
1307J2
EMPIRE BC/BS PPO
NY
01
1444783
FIRST HEATH/COVENTRY
NY
01
1865684
UNITED HEALTHCARE
NY
01
201787
METROPLUS
NY
01
201787-NY
1199
NY
01
20178701
NEIGHBORHOOD
NY
01
4C1004
HEALTHNET
NY
01
5158655
AETNA
NY
01
9764439
CIGNA
NY
01
P3652400
OXFORD FREEDOM
NY
01
RR118757
GHI PPO
NY
01
RR1787
ATLANTIS
NY
Enumeration date
01/17/2008
Last updated
01/27/2023
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