Individual
KELLY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
11 IRVING PL, WOODMERE, NY 11598-1256
(917) 582-2031
Mailing address
15 CLUBSIDE DR, WOODMERE, NY 11598-1363
(917) 582-2031
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
001154
NY
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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