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General NPI Number Information
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NPI Number | 1770441404
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Entity Type | Individual
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Provider Name | NICHOLAS ROSEN
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BOULEVARD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 585-738-5468
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Fax |
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Provider Business Mailing Address
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Address Line | 4 OLDE ORCHARD LN
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City | FAIRPORT
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State | NY
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Zip | 14450-2467
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Country | US
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Telephone | 585-738-5468
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 34143
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License Number State | NC
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