Individual
MS. MARISA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PT, SCS, ATC
Contact information
Practice address
2 5TH AVE, APT 11R, NEW YORK, NY 10011-8838
(917) 324-5358
(212) 656-1874
Mailing address
2 5TH AVE, APT 11R, NEW YORK, NY 10011-8838
(917) 324-5358
(212) 656-1874
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
0214651
NY
261QP2000X
Physical Therapy Clinic/Center
021465
NY
Other
Enumeration date
06/04/2007
Last updated
12/15/2020
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