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General NPI Number Information
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NPI Number | 1407023997
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Entity Type | Organization
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Legal Business Name | DUSTY ROSE IN RYE BROOK
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 114 S RIDGE ST
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City | RYE BROOK
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State | NY
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Zip | 10573-2813
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Country | US
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Telephone | 914-934-0775
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Fax |
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Provider Business Mailing Address
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Address Line | 114 S RIDGE ST
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City | RYE BROOK
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State | NY
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Zip | 10573-2813
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Country | US
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Telephone | 914-934-0775
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. MARILYN DEE WEISSMAN
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Credential |
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Telephone | 914-934-0775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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