Provider Demographics
NPI:1447660675
Name:LA ROSA, FRANCESCA
Entity type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:
Last Name:LA ROSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2277
Mailing Address - Country:US
Mailing Address - Phone:631-584-6152
Mailing Address - Fax:631-584-8063
Practice Address - Street 1:487 LAKE AVE
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2277
Practice Address - Country:US
Practice Address - Phone:631-584-6152
Practice Address - Fax:631-584-8063
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2813991207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine