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General NPI Number Information
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NPI Number | 1609986892
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Entity Type | Individual
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Provider Name | ELLIOTT H. ROSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 895 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10021-0327
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Country | US
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Telephone | 212-639-1346
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Fax |
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Provider Business Mailing Address
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Address Line | 15 RICHBELL RD
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City | SCARSDALE
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State | NY
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Zip | 10583-4434
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Country | US
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Telephone | 914-725-0363
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 170409-1
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License Number State | NY
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