Active NPI
Nicola Roselli
- Customized Equipment (DME)
- Valley Stream, NY
National Provider Identifier
1740818491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q58072 | Other | NY | MEDICARE |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Occupational Therapist
- Gainesville, FL
- NPI 1215593967
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.