Provider Demographics
NPI:1164680120
Name:JOSEPH, ROSE CHERINE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:CHERINE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E 19TH ST
Mailing Address - Street 2:APT. 2C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4879
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 E 19TH ST
Practice Address - Street 2:APT. 2C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4879
Practice Address - Country:US
Practice Address - Phone:917-474-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290670-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse