Individual
ROSEMARY PERTAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13049 122ND ST, SOUTH OZONE PARK, NY 11420-2707
(646) 418-2728
Mailing address
13049 122ND ST, SOUTH OZONE PARK, NY 11420-2707
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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