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General NPI Number Information
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NPI Number | 1558551853
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Entity Type | Individual
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Provider Name | ROSEMARIE CORLESS PNP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 1275 YORK AVE MSKCC PDH
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 212-639-7951
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 BLUE ST
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-2812
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Country | US
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Telephone | 516-783-3152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 380438
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License Number State | NY
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