Individual ProviderLoretta Romina RosalesSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address249 Collfield Ave, Staten Island, NY 10314-1929(347) 631-5471PECOS EnrollmentBased on the most recent information from CMS, provider Loretta Romina Rosales does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1104284645Provider TypeIndividualFull NameRosales, Loretta RominaGenderFemaleSole ProprietorNoEnumeration Date1/28/2016Last Updated1/28/2016Contact InformationPractice LocationPractice Address249 Collfield Ave, Staten Island, NY 10314-1929Phone(347) 631-5471FaxUnlisted FaxMailing LocationMailing Address249 Collfield Ave, Staten Island, NY 10314-1929PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense022524-1New York