Provider Demographics
NPI:1992834956
Name:ROSSI, DINA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:MARIE
Last Name:ROSSI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 BAYMAR DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-3438
Mailing Address - Country:US
Mailing Address - Phone:330-792-9949
Mailing Address - Fax:
Practice Address - Street 1:5320 YOUNGSTOWN RD
Practice Address - Street 2:SEARS OPTICAL,
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446
Practice Address - Country:US
Practice Address - Phone:330-652-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4872 T1737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist