Provider Demographics
NPI:1275841520
Name:ISAAC, ROSE EMRIS GERALDE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ROSE EMRIS
Middle Name:GERALDE
Last Name:ISAAC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CAROL LN
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1712
Mailing Address - Country:US
Mailing Address - Phone:914-633-7229
Mailing Address - Fax:
Practice Address - Street 1:23 CAROL LN
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1712
Practice Address - Country:US
Practice Address - Phone:914-633-7229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist