Active NPI
Gary Samuel Rose
- Pediatric Pathology Physician
- Wilmington, DE
National Provider Identifier
1770978108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pathology Physician
- License
- C1-0026244
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803-3607 - Phone
- (302) 651-4200
- Fax
- (302) 651-4945
- NPI assigned
- Apr 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pathology Physician | 207ZP0213X | C1-0026244 | DE | Primary |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803-3607
Mailing address
PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-6718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0026244 | DE | MD | Pediatric Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1770978108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6718",
"fax_number": "301-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 ROCKLAND RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198033607",
"telephone_number": "302-651-4200",
"fax_number": "302-651-4945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "GARY",
"middle_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-02",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0213X",
"taxonomy_group": "",
"desc": "Pathology, Pediatric Pathology",
"state": "DE",
"license": "C1-0026244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.