Provider Demographics
NPI:1477815074
Name:ROSSI, NICOLE RENEE (MS ED)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:RENEE
Last Name:ROSSI
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 S AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-4524
Mailing Address - Country:US
Mailing Address - Phone:518-852-0313
Mailing Address - Fax:
Practice Address - Street 1:72 S AMHERST AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-4524
Practice Address - Country:US
Practice Address - Phone:518-852-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist