Individual
ANGELA EVE DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 W HAWTHORNE AVE, VALLEY STREAM, NY 11580-6223
(516) 569-6600
Mailing address
2720 203RD ST, BAYSIDE, NY 11360-2333
(516) 238-1259
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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