Provider Demographics
NPI:1134258593
Name:ROSMARY N. LIBRE, INC.
Entity type:Organization
Organization Name:ROSMARY N. LIBRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIBRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-633-3939
Mailing Address - Street 1:175 MEMORIAL HWY
Mailing Address - Street 2:SUITE 1-14
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5635
Mailing Address - Country:US
Mailing Address - Phone:914-633-3939
Mailing Address - Fax:212-740-5163
Practice Address - Street 1:175 MEMORIAL HWY
Practice Address - Street 2:SUITE 1-14
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5635
Practice Address - Country:US
Practice Address - Phone:914-633-3939
Practice Address - Fax:212-740-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149570207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00700303Medicaid
NY00700303Medicaid
NYD47788Medicare UPIN
NY00700303Medicaid