Provider Demographics
NPI:1891248613
Name:DEFINO, ROSITA GUBIO (MS, RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:ROSITA
Middle Name:GUBIO
Last Name:DEFINO
Suffix:
Gender:F
Credentials:MS, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 RAFT AVE
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-5909
Mailing Address - Country:US
Mailing Address - Phone:631-880-2446
Mailing Address - Fax:
Practice Address - Street 1:158 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2005
Practice Address - Country:US
Practice Address - Phone:212-535-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307884363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care