Provider Demographics
NPI:1568895233
Name:BUCKLEY, ROSEMARIE OLIVE (RN)
Entity Type:Individual
Prefix:MISS
First Name:ROSEMARIE
Middle Name:OLIVE
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:R
Other - Middle Name:O
Other - Last Name:JAMES-BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:146 02 123 AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1622
Mailing Address - Country:US
Mailing Address - Phone:347-438-7110
Mailing Address - Fax:718-848-0094
Practice Address - Street 1:146 02 123 AVE
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11432-1622
Practice Address - Country:US
Practice Address - Phone:347-438-7110
Practice Address - Fax:718-848-0094
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY567949163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical