Provider Demographics
NPI:1376514588
Name:CHOW, ROSANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSANA
Middle Name:
Last Name:CHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2386
Mailing Address - Country:US
Mailing Address - Phone:617-924-6484
Mailing Address - Fax:
Practice Address - Street 1:63 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2386
Practice Address - Country:US
Practice Address - Phone:617-924-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74932207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3091830Medicaid
MAF29182Medicare UPIN
MAJ12571Medicare ID - Type Unspecified