Provider Demographics
NPI:1013075332
Name:ROSE, ANNA MARIA (ADULT NURSE PRACTITI)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MARIA
Last Name:ROSE
Suffix:
Gender:F
Credentials:ADULT NURSE PRACTITI
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:RODRUGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADULT NURSE PRACTITI
Mailing Address - Street 1:14 MOCKINGBIRD COURT
Mailing Address - Street 2:ANNA ROSE
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5246
Mailing Address - Country:US
Mailing Address - Phone:845-227-5606
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PARKWAY
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-6079
Practice Address - Fax:718-918-7788
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3004511163W00000X
NYF301194363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse