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NPI 1972736429

NPI 1972736429 : ROSEMARY A. VEROW-FREITAG RPA-C : WEST ISLIP, NY

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General NPI Number Information
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    NPI Number           |    1972736429
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    Entity Type          |    Individual 
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    Provider Name        |    ROSEMARY A. VEROW-FREITAG RPA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/01/2009
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    Last Update Date     |    09/01/2009
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Provider Practice Location Address
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    Address Line         |    556 MONTAUK HWY. 
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    City                 |    WEST ISLIP
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    State                |    NY
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    Zip                  |    11795-4407
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    Country              |    US
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    Telephone            |    631-321-4811
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    Fax                  |    631-321-4814
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Provider Business Mailing Address
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    Address Line         |    556 MONTAUK HIGHWAY 
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    City                 |    WEST ISLIP
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    State                |    NY
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    Zip                  |    11795-4407
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    Country              |    US
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    Telephone            |    631-321-4811
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    Fax                  |    631-321-4814
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    003242-1
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    License Number State |    NY
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