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General NPI Number Information
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NPI Number | 1730418492
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Entity Type | Organization
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Legal Business Name | DR FRANK V DEROSA PC
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 10111 101ST AVE
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City | OZONE PARK
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State | NY
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Zip | 11416-2612
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Country | US
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Telephone | 718-641-7700
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Fax | 718-323-1174
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Provider Business Mailing Address
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Address Line | 101-11 101ST AVENUE
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City | OZONE PARK
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State | NY
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Zip | 11416-9998
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Country | US
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Telephone | 718-641-7700
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Fax | 718-323-1174
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Authorized Official
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Title or Position | MANAGER
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Name | MISS BETTY ANDRIANO
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Credential |
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Telephone | 718-641-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X003072-1
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License Number State | NY
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