Provider Demographics
NPI:1306018775
Name:ROSE, JULIEN (CNM,)
Entity Type:Individual
Prefix:MS
First Name:JULIEN
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:CNM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7813
Mailing Address - Country:US
Mailing Address - Phone:212-477-8864
Mailing Address - Fax:212-473-4970
Practice Address - Street 1:279 E 3RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7813
Practice Address - Country:US
Practice Address - Phone:212-477-8864
Practice Address - Fax:212-473-4970
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000795367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife