Provider Demographics
NPI:1164195616
Name:ROSARIO, MELISSA (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 88TH ST APT A5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3516
Mailing Address - Country:US
Mailing Address - Phone:718-415-3228
Mailing Address - Fax:
Practice Address - Street 1:1 EMBARCADERO CTR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3628
Practice Address - Country:US
Practice Address - Phone:718-415-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174H00000X
DC174H00000X
CA174H00000X
MA174H00000X
IL174H00000X
WA174H00000X
NY174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator