Provider Demographics
NPI:1598145245
Name:ROSADO, CARLOS III (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:ROSADO
Suffix:III
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3557
Mailing Address - Country:US
Mailing Address - Phone:646-330-3658
Mailing Address - Fax:
Practice Address - Street 1:9033 ELMHURST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7935
Practice Address - Country:US
Practice Address - Phone:718-457-7000
Practice Address - Fax:718-899-4955
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY686076163W00000X
NYF349395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse