Basic Information
Provider Information
NPI: 1861582587
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRENDELL
FirstName: ROSANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22 GRISSOM PL
Address2:  
City: SALT POINT
State: NY
PostalCode: 125782025
CountryCode: US
TelephoneNumber: 8452668707
FaxNumber:  
Practice Location
Address1: 230 NORTH RD
Address2:  
City: POUGHKEEPSIE
State: NY
PostalCode: 126011328
CountryCode: US
TelephoneNumber: 8454863582
FaxNumber: 8454863599
Other Information
ProviderEnumerationDate: 10/13/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WA0400X366334-1NYY Nursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)

No ID Information.


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