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Individual

ROBERT J ROOSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D. M.P.H.

Contact information

Practice address
1233 MAIN ST, HOLYOKE, MA 01040-5381
(413) 493-2085
Mailing address
1233 MAIN ST, SUITE 109, HOLYOKE, MA 01040-5381
(413) 493-2085

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
246743
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
255329
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00245643
NY
Enumeration date
03/16/2008
Last updated
02/11/2014
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