Individual
KRISTEN ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 MONTAUK HWY UNIT F, EAST MORICHES, NY 11940-1153
(631) 878-0795
Mailing address
43 SEMINOLE ST, SELDEN, NY 11784-2642
(631) 926-9559
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010800-1
NY
Other
Enumeration date
07/04/2021
Last updated
07/04/2021
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