Rosalie Banovich, NPP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F400724 Issued in NY

Practice address

565 Route 25a Ste 209
Miller Place, NY 11764-2600

Phone

(631) 445-6881

Fax

(631) 849-4926

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Juliana Kanji Psychiatric Services, PC

  • Neurology Physician
  • Huntington, NY
  • NPI 1053405001
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306941026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROCKLEDGE DR.",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "11967",
            "telephone_number": "631-445-6881",
            "fax_number": "631-729-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ROUTE 25A STE 209",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642600",
            "telephone_number": "631-445-6881",
            "fax_number": "631-849-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOVICH",
        "first_name": "ROSALIE",
        "credential": "NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCH NURSE PRACT. LIC",
            "identifier": "F400724",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "330804",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Emily Atkins
• Adam August, DPT
• Marc Ian Avvento, D.C.
• Roy V Baillard
• Balanced OT Wellness, PLLC
• Lucia Mary Barthes, MA, IBCLC
• Deborah Barton, RN
• Wendy Bauer
• Lisa Sharon Bayliss, OTR/L
• Karl Sheridan Bean, DDS

• Psychiatric/Mental Health Nurse Practitioner in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.