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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