Individual provider Active NPI

Sandra Rousso, RN, HWNC-BC

  • Registered Nurse
  • Tenafly, NJ
National Provider Identifier
1184042905
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR08042000 Issued in NJ
Practice address
125 Oak St
Tenafly, NJ 07670-3013
Phone
(201) 871-8375
NPI assigned
Mar 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR08042000 NJ Primary
Registered Nurse 163W00000X 8009356 NY

Addresses

Primary practice location

125 Oak St
Tenafly, NJ 07670-3013

Mailing address

125 Oak St
Tenafly, NJ 07670-3013
Phone (201) 871-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR08042000NJMDRegistered Nurse
8009356NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1184042905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OAK ST",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076703013",
            "telephone_number": "201-871-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAK ST",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076703013",
            "telephone_number": "201-871-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSO",
        "first_name": "SANDRA",
        "credential": "RN, HWNC-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR08042000",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "8009356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tenafly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.