Provider Demographics
NPI:1528385051
Name:HOWARD ROSAS DPM PC
Entity Type:Organization
Organization Name:HOWARD ROSAS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-569-3310
Mailing Address - Street 1:4960 BROADWAY
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-2314
Mailing Address - Country:US
Mailing Address - Phone:212-569-3310
Mailing Address - Fax:212-569-1967
Practice Address - Street 1:4960 BROADWAY
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2314
Practice Address - Country:US
Practice Address - Phone:212-569-3310
Practice Address - Fax:212-569-1967
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWARD ROSAS DPM PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004129332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01011458Medicaid
NY88484Medicare PIN
NY0703600001Medicare NSC
NYP44191Medicare UPIN