Provider Demographics
NPI:1275078099
Name:DOSSOUS, ROLANDE
Entity Type:Individual
Prefix:MS
First Name:ROLANDE
Middle Name:
Last Name:DOSSOUS
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 1:2245 OCEAN PKWY APT 4F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4859
Mailing Address - Country:US
Mailing Address - Phone:917-803-2228
Mailing Address - Fax:
Practice Address - Street 1:2245 OCEAN PKWY
Practice Address - Street 2:4F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4849
Practice Address - Country:US
Practice Address - Phone:917-803-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249727-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse