{
"Npi": {
"NPI": "1851376834",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROSA PHARMACY, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1603 SAINT NICHOLAS AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10040-3303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "212-923-2412",
"MailingAddressFaxNumber": "212-923-0410",
"FirstLinePracticeLocationAddress": "1603 SAINT NICHOLAS AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10040-3303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "212-923-2412",
"PracticeLocationAddressFaxNumber": "212-923-0410",
"EnumerationDate": "12/13/2005",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARIAS",
"AuthorizedOfficialFirstName": "GUSTAVO",
"AuthorizedOfficialMiddleName": "ADOLFO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "SR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "347-992-6771",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "025087",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}