Provider Demographics
NPI:1689459810
Name:ROSSO, ASIA (MS, RDN)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:ROSSO
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PINE ST APT 1719
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1422
Mailing Address - Country:US
Mailing Address - Phone:857-413-7844
Mailing Address - Fax:
Practice Address - Street 1:20 PINE ST APT 1719
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-1422
Practice Address - Country:US
Practice Address - Phone:857-413-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86371749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered