Individual
DR. JUAN DE ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 434-8802
(716) 434-0093
Mailing address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 434-8802
(716) 434-0093
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
117428-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00616317
—
NY
Enumeration date
09/13/2007
Last updated
07/14/2020
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