Healthcare Provider Details

I. General information

NPI: 1689943276
Provider Name (Legal Business Name): ROSEMARIE M. CUA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSEMARIE M. CUA PT, DPT

II. Dates (important events)

Enumeration Date: 12/28/2011
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 W CHEYENNE AVE STE 105
LAS VEGAS NV
89129-8411
US

IV. Provider business mailing address

6330 S EASTERN AVE SUITE #3
LAS VEGAS NV
89119-3104
US

V. Phone/Fax

Practice location:
  • Phone: 702-798-9601
  • Fax:
Mailing address:
  • Phone: 702-798-9601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034428-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2742
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: