Individual
DR. CAROLINE ROSE VIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 NORTHERN BLVD, GREAT NECK, NY 11021-4812
(516) 829-2273
(516) 829-2272
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435
(646) 846-3283
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
243869-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02916714
—
NY
Enumeration date
06/27/2007
Last updated
12/05/2019
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