MEDICARE: HOWARD ROSAS DPM PC

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	332B00000X	Durable Medical Equipment & Medical Supplies	N004129	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528385051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOWARD ROSAS DPM PC

Provider Business Mailing Address
First Line	:	4960 BROADWAY
Second Line	:	SUITE 1C
City	:	NEW YORK
State	:	NY
Zip	:	10034-2314
Country	:	US
Telephone Number	:	212-569-3310
Fax Number	:	212-569-1967

Provider Business Practice Location Address
First Line	:	4960 BROADWAY
Second Line	:	SUITE 1C
City	:	NEW YORK
State	:	NY
Zip	:	10034-2314
Country	:	US
Telephone Number	:	212-569-3310
Fax Number	:	212-569-1967

Authorized Official
Title or Position	:	PODIATRIST
Name	:	HOWARD ROSAS
Credential	:	DPM
Telephone Number	:	212-569-3310

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	04/23/2010

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