ROSALIE BANOVICH


Address: 565 Route 25a Ste 209, Miller Place, NY 11764-2600
Phone: 6314456881

ROSALIE BANOVICH (NPI# 1306941026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306941026
Entity Type Individual
Full Name ROSALIE BANOVICH
Credential NPP
Practice Address 565 Route 25a Ste 209
Miller Place
NY 11764-2600
Mailing Address 23 Rockledge Dr.
Shirley
NY 11967
Practice Telephone 6314456881
Practice Fax Number 6318494926
Mailing Telephone 6314456881
Mailing Fax Number 6317293484
Enumeration Date 2006-09-14
Last Update Date 2015-03-03
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
F400724 NY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY DEA MB1010191 01
NY REGISTERED NURSE 330804 01
NY PSYCH NURSE PRACT. LIC F400724 01

Office Location

Street Address 565 ROUTE 25A STE 209
City MILLER PLACE
State NY
Zip Code 11764-2600

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689151870 Jjr Lifecare Inc In Home Supportive Care 85 Echo Ave., Suite 5, Miller Place, NY 11764 2018-07-20
1447782172 Xuxin Zhang Dentist 555 Ny-25a, Miller Place, NY 11764 2017-03-31
1679972202 Tara Daniels Social Worker 595-20 Route 25a, Suite 20, Miller Place, NY 11764 2014-08-20
1063858355 Karen Ann Mcnulty Specialist 16 White Birch Circle, Miller Place, NY 11764 2013-05-14
1689918070 Katja Mercado Speech-Language Pathologist 3 Honey Lane, Miller Place, NY 11764 2012-11-26
1447526967 North Isle Chiropractic PC Chiropractor 93 Miller Place Rd., Miller Place, NY 11764 2012-03-29
1235404039 Divine Chiropractic LLC Chiropractor 465 Route 25a, Suite 1, Miller Place, NY 11764 2012-03-13
1124338611 Lisa Aitken Social Worker 15 Memorial Drive, Miller Place, NY 11764 2010-10-18
1659504876 Janet Lynn Karp Speech-Language Pathologist 36 Samuels Path, Miller Place, NY 11764 2009-09-04
1356577589 Marilee Somerville Physical Therapist 36 Sweetgum Ln, Miller Place, NY 11764 2009-06-02
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508147950 Pamela Jane Rathburn Nurse Practitioner 48 Samuels Path, Miller Place, NY 11764-1921 2011-08-30
1821156738 Miriam Garcia Nurse Practitioner 19 Henearly Dr, Miller Place, NY 11764-3307 2006-12-04

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1073113833 Natalie Grant-villegas Nurse Practitioner 1210 Fulton St Apt 1, Brooklyn, NY 11216-2003 2020-10-29
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1407455967 Marie J. Schwarz, Npp-bc PC Nurse Practitioner 133 E Main St Ste 3h, Babylon, NY 11702-3517 2020-10-25
1720687015 Ashley Winn Nurse Practitioner 367 E Chester St, Long Beach, NY 11561-2324 2020-10-19
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Competitor

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City MILLER PLACE
Zip Code 11764

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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