Provider Demographics
NPI:1326109109
Name:KEARING, ROSE MARIE (DC)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MARIE
Last Name:KEARING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1435
Mailing Address - Country:US
Mailing Address - Phone:631-427-9391
Mailing Address - Fax:
Practice Address - Street 1:300 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1435
Practice Address - Country:US
Practice Address - Phone:631-427-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X21401Medicare ID - Type Unspecified