Individual
MS. TARA-GERMAINE ST. ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 BROADWAY FL 4, NEW YORK, NY 10006-1978
(212) 263-9700
Mailing address
111 BROADWAY FL 4, NEW YORK, NY 10006-1978
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421421
NY
363LW0102X
Women's Health Nurse Practitioner
PENDING
MD
Other
Enumeration date
01/20/2019
Last updated
06/08/2021
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