Provider Demographics
NPI:1801189584
Name:DEL ROSARIO, DEXTER NOLY LAURON (RN)
Entity Type:Individual
Prefix:MR
First Name:DEXTER NOLY
Middle Name:LAURON
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BAKER ST.
Mailing Address - Street 2:APT. 8B
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704
Mailing Address - Country:US
Mailing Address - Phone:322-423-6969
Mailing Address - Fax:
Practice Address - Street 1:8 BAKER ST.
Practice Address - Street 2:APT. 8B
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704
Practice Address - Country:US
Practice Address - Phone:322-423-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY633-843-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse