Provider Demographics
NPI:1184447211
Name:NIEVES, ROSA I
Entity type:Individual
Prefix:MS
First Name:ROSA
Middle Name:I
Last Name:NIEVES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ROBINS DR
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10919-3108
Mailing Address - Country:US
Mailing Address - Phone:347-514-4811
Mailing Address - Fax:
Practice Address - Street 1:13 ROBINS DR
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:10919-3108
Practice Address - Country:US
Practice Address - Phone:347-514-4811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency