Provider Demographics
NPI:1982085734
Name:THOMAS G ROSANO PHD LLC
Entity type:Organization
Organization Name:THOMAS G ROSANO PHD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:WOLF
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-534-5227
Mailing Address - Street 1:140 58 STREET BLDG A UNIT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:718-534-5227
Mailing Address - Fax:929-252-9176
Practice Address - Street 1:150 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3423
Practice Address - Country:US
Practice Address - Phone:518-695-5227
Practice Address - Fax:518-695-3784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE BIO CLINICAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-17
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPFI8451291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory