Healthcare Provider Details

I. General information

NPI: 1265342141
Provider Name (Legal Business Name): ORIANA GOLDEN SKYE ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 SOUTH NEW STREET
WEST CHESTER PA
19383-0001
US

IV. Provider business mailing address

12 BALA AVE APT 4
BALA CYNWYD PA
19004-3163
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-1000
  • Fax:
Mailing address:
  • Phone: 215-696-2570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: