Rosalie D Iraci, MD
Individual provider Active NPI Ophthalmology Physician · Corona, NY
NPI 1124280078 · NPPES record last updated Nov 22, 2017
Key facts
- NPI
- 1124280078
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 127539 (NY)
- Practice address
- 5004 111TH St
Corona, NY 11368-2918 - Phone
- (718) 592-7900
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127539 | NY | MD | Ophthalmology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 127539 | NY | Yes |
Addresses
Primary practice location
5004 111TH St
Corona, NY 11368-2918
Mailing address
35 Bretton Ridge Road
Mount Kisco, NY 10549
Phone (914) 666-9315
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All providers in Corona, NY · Ophthalmology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.