Healthcare Provider Details

I. General information

NPI: 1003926908
Provider Name (Legal Business Name): KAREN MICHELE ROSEWATER MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 EAST 90TH STREET
NEW YORK NY
10128
US

IV. Provider business mailing address

1270 5TH AVENUE #6D
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-987-1414
  • Fax: 212-987-1518
Mailing address:
  • Phone: 212-517-7237
  • Fax: 212-987-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number217822
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: