Healthcare Provider Details

I. General information

NPI: 1649100892
Provider Name (Legal Business Name): JULIO ROSARIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 LINCOLN DR E STE 201
MARLTON NJ
08053-3105
US

IV. Provider business mailing address

10000 LINCOLN DR E STE 201
MARLTON NJ
08053-3105
US

V. Phone/Fax

Practice location:
  • Phone: 856-431-2755
  • Fax:
Mailing address:
  • Phone: 856-431-2755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: