Individual
MS. IRIS B ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 CLARK ST APT 14H, BROOKLYN, NY 11201-7801
(917) 771-3737
Mailing address
101 CLARK ST APT 14H, BROOKLYN, NY 11201-7801
(917) 771-3737
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
16656
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16656
EARLY INTERVENTION SERVICE COORDINATOR
NY
Enumeration date
06/07/2012
Last updated
06/07/2012
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