Organization
MICHAEL DEROSA NP ADULT HEALTH PC
Active
Organization
MICHAEL DEROSA NP ADULT HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DEROSA NP (PRESIDENT)
(516) 983-3452
Entity
Organization
Contact information
Practice address
314 E MAIN ST, SMITHTOWN, NY 11787-2901
(516) 983-3452
Mailing address
4 BRASSWOOD RD, SAINT JAMES, NY 11780-3410
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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