Organization
OPTIMUM MENS HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ROSARIO DNP, AGNP (OWNER/MANAGING PARTNER)
(631) 486-9100
Entity
Organization
Contact information
Practice address
1056 W JERICHO TPKE, SMITHTOWN, NY 11787-3212
(631) 486-9100
(631) 486-9102
Mailing address
1056 W JERICHO TPKE, SMITHTOWN, NY 11787-3212
(631) 486-9100
(631) 486-9102
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346682739
—
NY
05
—
1427512763
—
NY
Enumeration date
05/18/2019
Last updated
05/18/2019
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