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General NPI Number Information
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NPI Number | 1629613476
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Entity Type | Organization
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Legal Business Name | CARE ANY AGE ADULT HEALTH NP, P.C.
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 3000 OCEAN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11235-8374
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Country | US
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Telephone | 646-460-7199
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Fax |
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Provider Business Mailing Address
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Address Line | 99 WALL ST # 326
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City | NEW YORK
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State | NY
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Zip | 10005-4301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NP
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Name | NATALIA ROTH
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Credential |
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Telephone | 646-460-7199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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