Provider Demographics
NPI:1255325064
Name:DANIELE, ROSE MARY ANN (RN, CS, MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:ROSE MARY
Middle Name:ANN
Last Name:DANIELE
Suffix:
Gender:F
Credentials:RN, CS, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8687 BAY 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4513
Mailing Address - Country:US
Mailing Address - Phone:718-256-0838
Mailing Address - Fax:718-256-6144
Practice Address - Street 1:1280 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-3204
Practice Address - Country:US
Practice Address - Phone:718-455-9000
Practice Address - Fax:718-452-6112
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330846-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01964254Medicaid