Rosales, Manuel R
Rosales, Manuel R is an individual health care provider with primary practice located at 388 Hawkins Ave Ste 1, Lake Ronkonkoma NY 11779-4280. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rosales, Manuel R can be contacted via phone (631) 588-8460.Contact Information
Primary practice address
388 Hawkins Ave Ste 1
Lake Ronkonkoma NY 11779-4280
Phone: (631) 588-8460
Fax: (631) 588-8480
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 207409 | New York |
Profile Details
NPI number | 1487656740 |
---|---|
LBN Legal business name | Rosales, Manuel R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 1st, 2005 |
Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1487656740 | NPPES |
New York | MEDICAID | 01762096 |
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