Individual
MRS. SHAUNA KEAGUE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5290
Mailing address
33 PRINCETON ST, GARDEN CITY, NY 11530-4005
(516) 526-0548
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
780438
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406151-01
NY
Other
Enumeration date
05/30/2024
Last updated
07/16/2024
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