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

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

## Provider details

- **NPI number:** 1467590455
- **Authorized official:** DR. NICHOLAS P. ROUSSIS M.D. (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (718) 921-1100

## Contact information

- **Practice address:** 9920 4TH AVE, SUITE 303, BROOKLYN, NY 11209-8333
- **Practice address phone:** (718) 921-1100
- **Practice address fax:** (718) 921-7100
- **Mailing address:** 4735 HYLAN BLVD, STATEN ISLAND, NY 10312-6313
- **Mailing address phone:** (718) 921-1100
- **Mailing address fax:** (718) 921-7100

## Taxonomy

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

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 08/22/2020