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General NPI Number Information
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NPI Number | 1891019170
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Entity Type | Individual
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Provider Name | NOVELETT ROSS
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Gender | Female
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 2581 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-2412
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Country | US
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Telephone | 718-385-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 117-27 193RD STREET
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City | ST. ALBANS
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State | NY
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Zip | 11412
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Country | US
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Telephone | 718-749-2478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0707221
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License Number State | NY
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