Healthcare Provider Details

I. General information

NPI: 1952926818
Provider Name (Legal Business Name): EDUARDO ROJAS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 5TH AVE
BROOKLYN NY
11209-2704
US

IV. Provider business mailing address

108 RIVER MEWS LN
EDGEWATER NJ
07020-3101
US

V. Phone/Fax

Practice location:
  • Phone: 718-439-5111
  • Fax:
Mailing address:
  • Phone: 347-816-6132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF345146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: