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NPI Code Detail

MEDICARE: NICOLA ROSELLI

MEDICARE: NICOLA ROSELLI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)0053121NY

General Provider Information

NPI Number : 1063688471
Entity Type Code : Organization
Provider Name (Legal Business Name) : NICOLA ROSELLI
Provider Business Mailing Address
First Line : 5847 FRANCIS LEWIS BLVD STE 200
Second Line :
City : OAKLAND GARDENS
State : NY
Zip : 11364-1601
Country : US
Telephone Number : 718-454-0842
Fax Number : 718-454-1704
Provider Business Practice Location Address
First Line : 931A MORRIS PARK AVE
Second Line :
City : BRONX
State : NY
Zip : 10462-3711
Country : US
Telephone Number : 718-822-4054
Fax Number : 718-454-1704
Authorized Official
Title or Position : SOLE PROPRIETOR
Name : MR. NICOLA ROSELLI
Credential : OTR CHT
Telephone Number : 718-454-0842
Provider Enumeration Date : 05/06/2008
Last Update Date : 06/11/2024

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