MEDICARE: ONOFRIO ROCCO CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2495515	NY

General Provider Information

NPI Number	:	1548480544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONOFRIO ROCCO CRNA

Provider Business Mailing Address
First Line	:	14 DEKALB AVE FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5311
Country	:	US
Telephone Number	:	718-408-4999
Fax Number	:	347-296-8176

Provider Business Practice Location Address
First Line	:	14 DEKALB AVE FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5311
Country	:	US
Telephone Number	:	718-408-4999
Fax Number	:	347-296-8176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	06/06/2023

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