Provider Demographics
NPI:1235401571
Name:VECCHI, ROSANE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:ROSANE
Middle Name:
Last Name:VECCHI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:ROSANE
Other - Middle Name:
Other - Last Name:VECCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ROSANE CAMPOS VECCHI
Mailing Address - Street 1:8245 135TH ST
Mailing Address - Street 2:5 K
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:347-563-3422
Mailing Address - Fax:
Practice Address - Street 1:4209 28TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4130
Practice Address - Country:US
Practice Address - Phone:917-485-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY607044163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1235401571Medicaid
NY1235401571Medicare NSC