Provider Demographics
NPI:1619267218
Name:NOUVINI, ROSA (MD)
Entity Type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:
Last Name:NOUVINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-444-2065
Mailing Address - Fax:
Practice Address - Street 1:DEPT. OF MEDICINE HSC T16
Practice Address - Street 2:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-2943
Practice Address - Country:US
Practice Address - Phone:631-444-4000
Practice Address - Fax:631-444-2493
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277091-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine