Individual
JOSEPH J DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MMC. CARDIOTHORACIC SURGERY 1575 BLONDELL AVE., SUITE 125, BRONX, NY 10461
(718) 920-4799
(718) 653-2237
Mailing address
MMC. CARDIOTHORACIC SURGERY 3400 BAINBRIDGE AVE., 5TH FLOOR, BRONX, NY 10467-2490
(718) 920-4799
(718) 653-2237
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2028061
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2028061
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02149333
—
NY
Enumeration date
12/07/2005
Last updated
11/02/2011
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