Individual
DIANE ROSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1011 N ELMER AVE, SAYRE, PA 18840-1832
(570) 887-3070
(570) 887-3382
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP013696
PA
363LF0000X
Family Nurse Practitioner
331275
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01630340
—
NY
01
—
161355553
BUSINESS TAX ID
—
Enumeration date
07/06/2006
Last updated
03/16/2021
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