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General NPI Number Information
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NPI Number | 1992834956
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Entity Type | Individual
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Provider Name | DINA MARIE ROSSI O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5320 YOUNGSTOWN RD SEARS OPTICAL,
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City | NILES
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State | OH
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Zip | 44446
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Country | US
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Telephone | 330-652-9097
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Fax |
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Provider Business Mailing Address
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Address Line | 4009 BAYMAR DR
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-3438
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Country | US
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Telephone | 330-792-9949
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4872 T1737
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License Number State | OH
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