Individual
STEPHANIE ANGELA VAN ROSSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28-18 ASTORIA BLVD, ASTORIA, NY 11102, ASTORIA, NY 11102
(917) 410-6905
Mailing address
9901 164TH AVE, HOWARD BEACH, NY 11414-4009
(718) 551-4588
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421399
NY
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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