Glen Nicolosi, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

208691 Issued in NY

Practice address

1330 Howard Rd
Rochester, NY 14624-2851

Phone

(585) 755-8784

NPI assigned

Jul 15, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1275821928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 HOWARD RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146242851",
            "telephone_number": "585-755-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 HOWARD RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146242851",
            "telephone_number": "585-755-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOSI",
        "first_name": "GLEN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "208691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elias Nicolas, MD
• Nicole Rowland, LCSW PLLC
• Nancy M Nicoletta, RPH.
• Renee C Nicoletta, R.N.
• Laurie Nicoll
• Nicosia Dental DDS PLLC
• Brandon Nicosia, DPT
• Nicholas Edward Nicosia, D.D.S.
• Andra Niculescu, MS, LMFT
• Amy Niederst

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.