Healthcare Provider Details

I. General information

NPI: 1336101807
Provider Name (Legal Business Name): ADAM R ROSATI JR. O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 HAMILTON BLVD
ALLENTOWN PA
18106-9113
US

IV. Provider business mailing address

1530 8TH AVE SUITE 102
BETHLEHEM PA
18018-1883
US

V. Phone/Fax

Practice location:
  • Phone: 610-530-4444
  • Fax: 610-366-1343
Mailing address:
  • Phone: 610-691-3335
  • Fax: 691-974-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberAHL2833746
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000927
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: