Individual
MR. KENNETH M ROSE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 CENTRAL PARK W, NEW YORK, NY 10023-6011
(212) 888-7773
(212) 421-7930
Mailing address
75 CENTRAL PARK W, NEW YORK, NY 10023-6011
(212) 888-7773
(212) 421-7930
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
188699
NY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
188699
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01776865
—
NY
01
—
6015129
GHI
NY
01
—
N28073
HEALTHNET
NY
Enumeration date
01/26/2007
Last updated
06/22/2009
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