Healthcare Provider Details

I. General information

NPI: 1902952666
Provider Name (Legal Business Name): DAWN ELIZABETH ROSACKER CPHT,CMF,COF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W MAIN ST
NORWICH CT
06360-5413
US

IV. Provider business mailing address

625 PLAINFIELD RD
JEWETT CITY CT
06351-1025
US

V. Phone/Fax

Practice location:
  • Phone: 860-889-8785
  • Fax:
Mailing address:
  • Phone: 860-376-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberC22508
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: