Provider Demographics
NPI:1942072087
Name:WHITE-MARTIN, ROSAMUND VERONICA
Entity Type:Individual
Prefix:
First Name:ROSAMUND
Middle Name:VERONICA
Last Name:WHITE-MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 NORTHGATE CT
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3016
Mailing Address - Country:US
Mailing Address - Phone:516-582-5020
Mailing Address - Fax:
Practice Address - Street 1:1067 NORTHGATE CT
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3016
Practice Address - Country:US
Practice Address - Phone:516-582-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist