Derosa, Raffaella
Derosa, Raffaella is an individual health care provider with primary practice located at 2817 Reilly St , Fort Bragg NC 28310-5001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Derosa, Raffaella can be contacted via phone (910) 907-8236.Contact Information
Primary practice address
2817 Reilly St
Fort Bragg NC 28310-5001
Phone: (910) 907-8236
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 16588 | Hawaii |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 306408 | North Carolina |
Profile Details
| NPI number | 1568756351 |
|---|---|
| LBN Legal business name | Derosa, Raffaella |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2011 |
| Last updated | Sep 26th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568756351 | NPPES |
| Hawaii | MEDICAID | VAD000 |
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