=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508764598
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSANNA MARTE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2026
-----------------------------------------------------
Last Update Date | 10/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 ROUTE 111 STE 300
-----------------------------------------------------
City | SMITHTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11787-3700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-352-3556
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 ROY DR
-----------------------------------------------------
City | NESCONSET
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11767-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-334-1435
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | F311255-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------