Individual
MS. ROSA HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
234 EAST 149TH STREET, MEDICINE DEPARTMENT 8TH FLOOR, BRONX, NY 10451
(718) 579-5182
Mailing address
776 MACE AVE APT E5, BRONX, NY 10467-9131
(917) 428-6599
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
338421
NY
Other
Enumeration date
12/23/2013
Last updated
12/23/2013
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