Individual
ROSE CORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 562-6000
Mailing address
48 LAUREL COVE RD, OYSTER BAY, NY 11771-1920
(516) 574-3163
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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