# NICHOLAS P. ROUSSIS, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023156361
- **Authorized official:** DR. NICHOLAS P. ROUSSIS M.D. (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (718) 667-4244

## Contact information

- **Practice address:** 2627B HYLAN BLVD, STATEN ISLAND, NY 10306-4303
- **Practice address phone:** (718) 667-4244
- **Practice address fax:** (718) 667-5510
- **Mailing address:** 4735 HYLAN BLVD, STATEN ISLAND, NY 10312-6313
- **Mailing address phone:** (718) 667-4244
- **Mailing address fax:** (718) 667-5510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 231555 | NY | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 01/14/2009