Healthcare Provider Details

I. General information

NPI: 1962440222
Provider Name (Legal Business Name): MELVIN SEYMOUR ROSH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PHILLIPS HILL RD #4
NEW CITY NY
10956-4132
US

IV. Provider business mailing address

PO BOX 236
NANUET NY
10954-0236
US

V. Phone/Fax

Practice location:
  • Phone: 914-441-3403
  • Fax: 212-996-3858
Mailing address:
  • Phone: 914-441-3403
  • Fax: 212-996-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number086123
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: