Elpidio S Rosario, DDS
Individual provider Active NPI Dentist · Jackson HTS, NY
NPI 1609885409 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609885409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 31108 (NY)
- Practice address
- 37-28 80TH St
Jackson HTS, NY 11372 - Phone
- (718) 898-5168
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31108 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31108 | NY | Yes |
Addresses
Primary practice location
37-28 80TH St
Jackson HTS, NY 11372
Mailing address
37-28 80TH St
Jackson HTS, NY 11372
Phone (718) 898-5168
Other providers in Jackson HTS, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.