Individual
STEPHANIE ROSARIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1184 EVERGREEN AVE APT 6D, BRONX, NY 10472-3235
(347) 494-3162
Mailing address
1184 EVERGREEN AVE APT 6D, BRONX, NY 10472-3235
(347) 494-3162
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
NY
01
—
NA
NA
—
Enumeration date
10/27/2020
Last updated
10/27/2020
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