Healthcare Provider Details

I. General information

NPI: 1164330312
Provider Name (Legal Business Name): CRISTIAN RAFAEL ROSADO HHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 MONOCACY TRL
SPRING GROVE PA
17362-1512
US

IV. Provider business mailing address

2825 GRAND CONCOURSE APT 1H
BRONX NY
10468-1907
US

V. Phone/Fax

Practice location:
  • Phone: 347-873-0736
  • Fax:
Mailing address:
  • Phone: 914-446-5578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: