Healthcare Provider Details
I. General information
NPI: 1164566485
Provider Name (Legal Business Name): ROSEMARY M SZOLLAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/19/2007
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
153 BRODHEAD RD
BETHLEHEM PA
18017-8931
US
IV. Provider business mailing address
153 BRODHEAD RD
BETHLEHEM PA
18017-8931
US
V. Phone/Fax
- Phone: 484-526-3218
- Fax: 484-526-3180
- Phone: 484-526-3218
- Fax: 484-526-3180
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | ME 95988 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | MD447265 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: