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General NPI Number Information
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NPI Number | 1205648383
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Entity Type | Organization
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Legal Business Name | ROSE WELLNESS OF NY
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 74 GRAND AVE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-4957
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Country | US
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Telephone | 516-361-7812
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Fax |
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Provider Business Mailing Address
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Address Line | 3756 LIBBY LN
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City | WANTAGH
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State | NY
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Zip | 11793-1419
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Country | US
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Telephone | 516-238-1099
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JESSICA LAULETTI
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Credential | LAC
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Telephone | 516-361-7812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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