Healthcare Provider Details

I. General information

NPI: 1407141070
Provider Name (Legal Business Name): ROSETTE RUTH AGUILAR AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSETTE RUTH REISMAN AUD

II. Dates (important events)

Enumeration Date: 06/12/2011
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 ATLANTIC AVE 101
BROOKLYN NY
11201-6720
US

IV. Provider business mailing address

1994 E 22ND ST
BROOKLYN NY
11229-3616
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-5867
  • Fax:
Mailing address:
  • Phone: 347-200-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002333-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: