Healthcare Provider Details

I. General information

NPI: 1710640339
Provider Name (Legal Business Name): ROSA A EUSEBIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 N 16TH ST STE 720A
PHOENIX AZ
85020-5237
US

IV. Provider business mailing address

236 COLONY CT
PITTSBURGH PA
15205-1631
US

V. Phone/Fax

Practice location:
  • Phone: 602-293-8029
  • Fax: 480-581-7474
Mailing address:
  • Phone: 401-771-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: