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NPI Code Detail

MEDICARE: DR. JOHN WILLIAM ROSADO JR. PSY.D.

MEDICARE: DR. JOHN WILLIAM ROSADO JR. PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist35S100206300NJ

General Provider Information

NPI Number : 1992951776
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN WILLIAM ROSADO JR. PSY.D.
Provider Business Mailing Address
First Line : 149 W MAIN ST
Second Line :
City : FREEHOLD
State : NJ
Zip : 07728-2051
Country : US
Telephone Number : 732-780-9898
Fax Number : 732-780-6447
Provider Business Practice Location Address
First Line : 149 W MAIN ST
Second Line :
City : FREEHOLD
State : NJ
Zip : 07728-2051
Country : US
Telephone Number : 732-780-9898
Fax Number : 732-780-6447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2008
Last Update Date : 08/13/2008

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