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General NPI Number Information
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NPI Number | 1881724458
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Entity Type | Individual
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Provider Name | MARTIN DAVID ROSADO O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 41 MAMARONECK AVE
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4204
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Country | US
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Telephone | 914-946-0520
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Fax | 914-946-0821
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Provider Business Mailing Address
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Address Line | 63 MASSACHUSETTS AVE
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City | CONGERS
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State | NY
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Zip | 10920-2503
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Country | US
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Telephone | 845-267-8600
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006019
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License Number State | NY
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