Individual
DR. JEFFREY M. ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
224 SUNRISE MALL, MASSAPEQUA, NY 11758-4340
(516) 795-3030
(516) 795-2418
Mailing address
224 SUNRISE MALL, MASSAPEQUA, NY 11758-4340
(516) 795-3030
(516) 795-2418
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NY 003430-0
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-3270311
TAX ID#
—
Enumeration date
03/06/2007
Last updated
06/11/2008
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