=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912354051
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSITA CADALIN NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2016
-----------------------------------------------------
Last Update Date | 10/18/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9610 METROPOLITAN AVE
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-6625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-459-0400
-----------------------------------------------------
Fax | 718-670-6479
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 441 9TH AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-1623
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F338259-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------