Provider Demographics
NPI:1922128685
Name:ROSSETTI, VERONICA T (APN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:T
Last Name:ROSSETTI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 BLACK HORSE PIKE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:WEST ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-2016
Mailing Address - Country:US
Mailing Address - Phone:856-812-8089
Mailing Address - Fax:
Practice Address - Street 1:8025 BLACK HORSE PIKE
Practice Address - Street 2:SUITE 501
Practice Address - City:WEST ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08232-0823
Practice Address - Country:US
Practice Address - Phone:856-812-8089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07165600363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356Medicare Oscar/Certification
Q19357Medicare UPIN
NJ080918SK3Medicare PIN