Organization Active NPI

Nicola Roselli

  • Customized Equipment (DME)
  • Valley Stream, NY
National Provider Identifier
1740818491
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
NICOLA ROSELLI
Practice address
140 W Merrick Rd
Valley Stream, NY 11580-5511
Phone
(718) 454-0842
Fax
(718) 454-1704
NPI assigned
Mar 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Mr. Nick Roselli, OTR.CHT
Title
Occupational Therapist
Phone
(718) 454-0842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

140 W Merrick Rd
Valley Stream, NY 11580-5511

Mailing address

5847 Francis Lewis Blvd Ste 200
Oakland Gardens, NY 11364-1601
Phone (718) 454-0842

Other identifiers 1

IdentifierTypeStateIssuer
Q58072OtherNYMEDICARE

National Provider Directory

National Provider Directory

Locations

931 Morris Park Ave
#A
Bronx, NY 10462
Phone (718) 822-4054

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1740818491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5847 FRANCIS LEWIS BLVD STE 200",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113641601",
            "telephone_number": "718-454-0842",
            "fax_number": "718-454-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805511",
            "telephone_number": "718-454-0842",
            "fax_number": "718-454-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLA ROSELLI",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "ROSELLI",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "718-454-0842",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR.CHT"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q58072",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.