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General NPI Number Information
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NPI Number | 1225211881
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Entity Type | Organization
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Legal Business Name | ROSE CHIROPRACTIC, HEALTH & WELLNESS P.C.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 10825 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11433-2906
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Country | US
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Telephone | 718-658-9700
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Fax | 718-658-9703
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Provider Business Mailing Address
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Address Line | 10825 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11433-2906
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Country | US
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Telephone | 718-658-9700
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Fax | 718-658-9703
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROLAND M. ROSE
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Credential | D.C.
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Telephone | 718-658-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010712
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License Number State | NY
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