Provider Demographics
NPI:1134878291
Name:ROSEN, MEGAN ASHLEY (DVM)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ASHLEY
Last Name:ROSEN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25903 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2234
Mailing Address - Country:US
Mailing Address - Phone:718-749-3642
Mailing Address - Fax:
Practice Address - Street 1:VETCO TOTAL CARE - PETCO
Practice Address - Street 2:806 SUNRISE HIGHWAY
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-632-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015705208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice