Individual
ANNEMARIE LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 GLEN COVE AVE, GLEN COVE, NY 11542-3438
(516) 676-2388
Mailing address
28 CLUSTERPINE ST, MEDFORD, NY 11763-4204
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308386
NY
Other
Enumeration date
10/24/2012
Last updated
10/25/2012
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