Gayle Derosa, L.P.N.

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN-052307 Issued in OH

Practice address

6599 W Middletown Rd
Canfield, OH 44406-9417

Phone

(330) 503-1064

NPI assigned

Jan 3, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1154668606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6599 W MIDDLETOWN RD",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069417",
            "telephone_number": "330-503-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6599 W MIDDLETOWN RD",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069417",
            "telephone_number": "330-503-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "GAYLE",
        "name_prefix": "Mrs.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-052307",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN074657L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rea Joann Dawson
• Grace Deegan, LPC
• Brian J Dematteo, D.D.S.
• James Charles Demidovich, DO
• Dental Express, LLC
• Michael A Derosa, DO
• Diabetic Supplies, Inc.
• Pamela A Dickerhoof, RN03/22/1955
• Toni Dimargio, LPCC
• Michael Divito

• Licensed Practical Nurse in Canfield, OH
• Providers in Canfield, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.