Provider Demographics
NPI:1750486205
Name:ROSELLO, LORI JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:JEAN
Last Name:ROSELLO
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 1:46 W 11TH ST
Mailing Address - Street 2:W 11TH STREET PEDIATRIC ASSOCIATES, LLP
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8602
Mailing Address - Country:US
Mailing Address - Phone:212-529-4330
Mailing Address - Fax:212-598-0285
Practice Address - Street 1:46 W 11TH ST
Practice Address - Street 2:W 11TH STREET PEDIATRIC ASSOCIATES, LLP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8602
Practice Address - Country:US
Practice Address - Phone:212-529-4330
Practice Address - Fax:212-598-0285
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177536208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics