MEDICARE: ROSA DIPIETRANTONIO R.N.

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
1	163WC0400X	Case Management Registered Nurse	610405	NY
2	163WC1500X	Community Health Registered Nurse	610405	NY
3	163WC0200X	Critical Care Medicine Registered Nurse	610405	NY

General Provider Information

NPI Number	:	1558675090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA DIPIETRANTONIO R.N.

Provider Business Mailing Address
First Line	:	1302 HOBART AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-6017
Country	:	US
Telephone Number	:	347-219-3470
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 HOBART AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-6017
Country	:	US
Telephone Number	:	347-219-3470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	01/18/2023

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