MEDICARE: ROSE FAMILY HEALTH NP SERVICES PLLC

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	207N00000X	Dermatology Physician
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1972315091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSE FAMILY HEALTH NP SERVICES PLLC

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	:	205 E 125TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1739
Country	:	US
Telephone Number	:	917-773-8119
Fax Number	:	855-633-0004

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	DEBRANAYE ROSE
Credential	:	NP
Telephone Number	:	702-301-0900

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	10/21/2025

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