Provider Demographics
NPI:1194007260
Name:ROSSO, SUZANNE B (RN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:B
Last Name:ROSSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:B
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:100 GROTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4540
Mailing Address - Country:US
Mailing Address - Phone:585-359-3710
Mailing Address - Fax:585-359-2372
Practice Address - Street 1:100 GROTON PKWY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4540
Practice Address - Country:US
Practice Address - Phone:585-359-3710
Practice Address - Fax:585-359-2375
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264420-1164W00000X
NY668082163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse