Provider Demographics
NPI:1164950143
Name:ROSSATO-BENNETT, XIMENA (MSN, FNP-C, CNM)
Entity Type:Individual
Prefix:
First Name:XIMENA
Middle Name:
Last Name:ROSSATO-BENNETT
Suffix:
Gender:F
Credentials:MSN, FNP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CLARKSON AVE APT 3K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1956
Mailing Address - Country:US
Mailing Address - Phone:917-306-7731
Mailing Address - Fax:206-538-6296
Practice Address - Street 1:30 E 23RD ST STE 700
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4408
Practice Address - Country:US
Practice Address - Phone:646-650-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001847367A00000X
NY341649363LF0000X
CT16.000432176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily