Provider Demographics
NPI:1225395296
Name:ROSIAS, GRACIANNA
Entity Type:Individual
Prefix:MS
First Name:GRACIANNA
Middle Name:
Last Name:ROSIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST STE 1911
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-1119
Mailing Address - Country:US
Mailing Address - Phone:718-852-5470
Mailing Address - Fax:718-852-6972
Practice Address - Street 1:26 COURT ST STE 1911
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1119
Practice Address - Country:US
Practice Address - Phone:718-852-5470
Practice Address - Fax:718-852-6972
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator