Organization
NICOLA ROSELLI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK ROSELLI OTR.CHT (OCCUPATIONAL THERAPIST)
(718) 454-0842
Entity
Organization
Contact information
Practice address
140 W MERRICK RD, VALLEY STREAM, NY 11580-5511
(718) 454-0842
(718) 454-1704
Mailing address
5847 FRANCIS LEWIS BLVD STE 200, OAKLAND GARDENS, NY 11364-1601
(718) 454-0842
(718) 454-1704
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q58072
MEDICARE
NY
Enumeration date
03/30/2020
Last updated
06/11/2024
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