Provider Demographics
NPI:1205800539
Name:RAFFA, ROSEMARIE (NP)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:
Last Name:RAFFA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2518
Mailing Address - Country:US
Mailing Address - Phone:914-271-6262
Mailing Address - Fax:914-271-4839
Practice Address - Street 1:95 WOODS RD
Practice Address - Street 2:ONCOLOGY 7 SOUTH
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1557
Practice Address - Country:US
Practice Address - Phone:914-493-7488
Practice Address - Fax:914-493-7483
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5087581363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1139G1Medicare ID - Type Unspecified
Q46344Medicare UPIN