Individual
DR. ROSE MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9009 VAN WYCK EXPRESSWAY, JAMAICA, NY 11418-2832
(718) 206-5594
Mailing address
6433 99TH ST APT 4J, REGO PARK, NY 11374-3541
(347) 453-4005
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
260371
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
260371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03384916
—
NY
Enumeration date
07/01/2011
Last updated
02/28/2014
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