Healthcare Provider Details

I. General information

NPI: 1427714567
Provider Name (Legal Business Name): JOSHUA ALAN ROSANSKY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13039 ROUTE 50 STE C
FAIRFAX VA
22033-2047
US

IV. Provider business mailing address

PO BOX 791775
BALTIMORE MD
21279-1775
US

V. Phone/Fax

Practice location:
  • Phone: 571-307-2594
  • Fax: 571-307-2595
Mailing address:
  • Phone: 571-302-5000
  • Fax: 571-302-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008936
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: