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NPI Code Detail

MEDICARE: DEBRANAYE ROSE

MEDICARE:   DEBRANAYE  ROSE
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
1363LF0000XFamily Nurse Practitioner1232650NY

General Provider Information

NPI Number : 1922604172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRANAYE ROSE
Provider Business Mailing Address
First Line : 805 E 222ND ST
Second Line :
City : BRONX
State : NY
Zip : 10467-5107
Country : US
Telephone Number : 702-301-0900
Fax Number :
Provider Business Practice Location Address
First Line : 805 E 222ND ST
Second Line :
City : BRONX
State : NY
Zip : 10467-5107
Country : US
Telephone Number : 702-301-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2020
Last Update Date : 12/11/2020

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Directions to “ DEBRANAYE ROSE ” Practice Location

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