Individual
DR. STEVEN RICHARD ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 KETCHAM AVE, PATCHOGUE, NY 11772-2509
(631) 475-3540
Mailing address
101 KETCHAM AVE, PATCHOGUE, NY 11772-2509
(631) 475-3540
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005165-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01237892
—
NY
Enumeration date
04/13/2007
Last updated
07/08/2007
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