Healthcare Provider Details

I. General information

NPI: 1104430263
Provider Name (Legal Business Name): ANNMARIE JOHNSON-ROWE NP IN PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14240 249TH ST
ROSEDALE NY
11422-2144
US

IV. Provider business mailing address

14240 249TH ST
ROSEDALE NY
11422-2144
US

V. Phone/Fax

Practice location:
  • Phone: 347-290-2100
  • Fax:
Mailing address:
  • Phone: 347-290-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNMARIE JOHNSON-ROWE
Title or Position: CEO
Credential: NP
Phone: 347-290-2100