Provider Demographics
NPI:1710960372
Name:ROWE, GERMAINE N (MD)
Entity Type:Individual
Prefix:DR
First Name:GERMAINE
Middle Name:N
Last Name:ROWE
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 1:2535 ARTHUR KILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1207
Mailing Address - Country:US
Mailing Address - Phone:718-448-3210
Mailing Address - Fax:718-967-6023
Practice Address - Street 1:1099 TARGEE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4310
Practice Address - Country:US
Practice Address - Phone:718-448-3210
Practice Address - Fax:718-815-3379
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA769802081P2900X
NY20430012081P2900X, 208VP0000X
NJ25MA07698000208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02201063Medicaid
NY39B141Medicare PIN
NY02201063Medicaid