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Contact Information

CHARLES A LA ROSA, MD
15 PARK AVE
BAY SHORE, NY11706-7381
 Phone: 631-581-4400
 Fax: 631-277-3750
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for CHARLES A LA ROSA · (Male)

NPI Number 1619900438
Status Active
Credentials MD
Entity Individual
Enumeration date 07/07/2006
Last updated 12/01/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 167344
  • NY Medicaid 01480831
  • NY Other 167344 LICENSE
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
  • GOOD SAMARITAN HOSPITAL MEDICAL CENTER - (Acute Care)
    1000 MONTAUK HIGHWAY
    WEST ISLIP, NY 11795
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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