Individual
MARITZA DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
339 HICKS ST, LONG ISLAND COLLEGE HOSPITAL- DEPT. OF FAMILY MEDICINE, BROOKLYN, NY 11201-5509
(718) 780-4997
Mailing address
12 BAKLEY TER, WEST ORANGE, NJ 07052-2169
(973) 736-7179
(973) 736-2456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
185256
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1450480
—
NY
Enumeration date
10/25/2006
Last updated
07/08/2007
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