Provider Demographics
NPI:1508031196
Name:DE LA ROSA, NILA THERESA (MSN, RN, NP-C, OCN)
Entity Type:Individual
Prefix:MS
First Name:NILA
Middle Name:THERESA
Last Name:DE LA ROSA
Suffix:
Gender:F
Credentials:MSN, RN, NP-C, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 SPINNAKER CT
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2233
Mailing Address - Country:US
Mailing Address - Phone:201-867-8881
Mailing Address - Fax:
Practice Address - Street 1:560 1ST AVE
Practice Address - Street 2:TISCH HOSPITAL - 16 EAST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304845363LA2200X
NJ26NJ00143200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health