MEDICARE: ROSY ROBEEL AZER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1275117137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSY ROBEEL AZER

Provider Business Mailing Address
First Line	:	5405 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5201
Country	:	US
Telephone Number	:	917-397-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	5405 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5201
Country	:	US
Telephone Number	:	917-397-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2021
Last Update Date	:	09/09/2024

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Directions to “ ROSY ROBEEL AZER ” Practice Location

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