Provider Demographics
NPI:1982905774
Name:HOLGUIN, ROSITA PILAR
Entity Type:Individual
Prefix:MS
First Name:ROSITA
Middle Name:PILAR
Last Name:HOLGUIN
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 1:142 JEFFERSON ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-6101
Mailing Address - Country:US
Mailing Address - Phone:347-417-1825
Mailing Address - Fax:
Practice Address - Street 1:142 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-6101
Practice Address - Country:US
Practice Address - Phone:347-417-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1200757174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist