Healthcare Provider Details

I. General information

NPI: 1528612793
Provider Name (Legal Business Name): DR. THOMAS GERARD ROSANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NEW SCOTLAND AVE
ALBANY NY
12208-3423
US

IV. Provider business mailing address

150 NEW SCOTLAND AVE
ALBANY NY
12208-3423
US

V. Phone/Fax

Practice location:
  • Phone: 518-605-9041
  • Fax: 518-293-0208
Mailing address:
  • Phone: 518-605-9041
  • Fax: 518-293-0208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: