Healthcare Provider Details

I. General information

NPI: 1558675090
Provider Name (Legal Business Name): ROSA DIPIETRANTONIO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 HOBART AVE
BRONX NY
10461-6017
US

IV. Provider business mailing address

1302 HOBART AVE
BRONX NY
10461-6017
US

V. Phone/Fax

Practice location:
  • Phone: 347-219-3470
  • Fax:
Mailing address:
  • Phone: 347-219-3470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number610405
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number610405
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number610405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: