Basic Information
Provider Information
NPI: 1457983892
EntityType: 2
ReplacementNPI:  
OrganizationName: ROSIN EYECARE P.C.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6233 CERMAK RD
Address2:  
City: BERWYN
State: IL
PostalCode: 604022317
CountryCode: US
TelephoneNumber: 7087492020
FaxNumber:  
Practice Location
Address1: 4205 HILLSBORO PIKE STE 204
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372153387
CountryCode: US
TelephoneNumber: 6152982020
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/04/2020
LastUpdateDate: 02/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHIARAMONTI
AuthorizedOfficialFirstName: NICHOLAS
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 6305468319
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: OD
NPICertificationDate: 02/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X  Y193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


Home