Provider Demographics
NPI:1427899020
Name:ROSE, CYDNEY (MBE, BAN, RN)
Entity type:Individual
Prefix:
First Name:CYDNEY
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:MBE, BAN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CENTRE ST APT 1501
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-8600
Mailing Address - Country:US
Mailing Address - Phone:319-415-8621
Mailing Address - Fax:
Practice Address - Street 1:400 LAKEVILLE RD STE 225A
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1121
Practice Address - Country:US
Practice Address - Phone:516-470-5840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist