Individual
DEBRANAYE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 E 222ND ST, BRONX, NY 10467-5107
(702) 301-0900
Mailing address
805 E 222ND ST, BRONX, NY 10467-5107
(702) 301-0900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
346938
NY
363LF0000X
Family Nurse Practitioner
Primary
1232650
NY
Other
Enumeration date
12/11/2020
Last updated
03/16/2026
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