La Rosa, Charles A

La Rosa, Charles A is an individual health care provider with primary practice located at 15 Park Ave , Bay Shore NY 11706-7381. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. La Rosa, Charles A can be contacted via phone (631) 581-4400.

Contact Information

Primary practice address
15 Park Ave Bay Shore NY 11706-7381
Phone: (631) 581-4400
Fax: (631) 277-3750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 167344 New York

Profile Details

NPI number 1619900438
LBN Legal business name La Rosa, Charles A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Dec 1st, 2009 - about 15 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619900438 NPPES
New York Other 167344 LICENSE
New York MEDICAID 01480831 LICENSE

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