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General NPI Number Information
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NPI Number | 1720759863
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Entity Type | Individual
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Provider Name | PRIMROSE DEL ROSARIO
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 102 RIVERS EDGE RD
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City | NEW YORK
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State | NY
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Zip | 10035-1163
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Country | US
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Telephone | 646-766-4975
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Fax |
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Provider Business Mailing Address
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Address Line | 442 E 78TH ST APT 3D
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City | NEW YORK
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State | NY
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Zip | 10075-1616
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Country | US
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Telephone | 347-446-7930
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 403820
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License Number State | NY
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