Individual provider Active NPI

Cheryl Rovendro, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1730458175
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
494279-1 Issued in NY
Practice address
567 E 105TH St
Brooklyn, NY 11236-2213
Phone
(718) 307-3010
Fax
(718) 307-3020
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 494279-1 NY Primary

Addresses

Primary practice location

567 E 105TH St
Brooklyn, NY 11236-2213

Mailing address

567 E 105TH St
Brooklyn, NY 11236-2213
Phone (718) 307-3010

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
494279-1NYMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1730458175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 E 105TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362213",
            "telephone_number": "718-307-3010",
            "fax_number": "718-307-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 E 105TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362213",
            "telephone_number": "718-307-3010",
            "fax_number": "718-307-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVENDRO",
        "first_name": "CHERYL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "494279-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.