Provider Demographics
NPI:1174811806
Name:ROSE, LYNDON F (MD)
Entity type:Individual
Prefix:DR
First Name:LYNDON
Middle Name:F
Last Name:ROSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16303 HORACE HARDING EXPY
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1454
Mailing Address - Country:US
Mailing Address - Phone:718-670-4201
Mailing Address - Fax:718-670-4160
Practice Address - Street 1:16303 HORACE HARDING EXPY
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-1454
Practice Address - Country:US
Practice Address - Phone:718-670-4201
Practice Address - Fax:718-670-4160
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2239102083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine