Provider Demographics
NPI:1528483492
Name:NITTI, ROXANN
Entity type:Individual
Prefix:
First Name:ROXANN
Middle Name:
Last Name:NITTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 WINDFALL RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-8021
Mailing Address - Country:US
Mailing Address - Phone:315-738-1885
Mailing Address - Fax:
Practice Address - Street 1:1113 WINDFALL RD
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-738-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2638561164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse