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General NPI Number Information
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NPI Number | 1972315091
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Entity Type | Organization
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Legal Business Name | ROSE FAMILY HEALTH NP SERVICES PLLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 205 E 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10035-1739
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Country | US
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Telephone | 917-773-8119
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Fax | 855-633-0004
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Provider Business Mailing Address
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Address Line | 805 E 222ND ST
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City | BRONX
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State | NY
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Zip | 10467-5107
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Country | US
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Telephone | 702-301-0900
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DEBRANAYE ROSE
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Credential | NP
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Telephone | 702-301-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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