Healthcare Provider Details

I. General information

NPI: 1184548372
Provider Name (Legal Business Name): NEW IMAGE LASER CENTER,PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3817
US

IV. Provider business mailing address

2506 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3817
US

V. Phone/Fax

Practice location:
  • Phone: 586-703-3129
  • Fax:
Mailing address:
  • Phone: 586-703-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSANNA DAHER-KHACHO
Title or Position: OWNER
Credential: RN
Phone: 586-703-3129