Healthcare Provider Details

I. General information

NPI: 1053742809
Provider Name (Legal Business Name): DR. ROBERT ANTHONY ROSALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RIVER ST
WELLESLEY MA
02481-2098
US

IV. Provider business mailing address

42 WESTMOOR RD
BOSTON MA
02132-4710
US

V. Phone/Fax

Practice location:
  • Phone: 508-685-6480
  • Fax:
Mailing address:
  • Phone: 508-685-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number229003
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: