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1649946401 NPI number — JOHN JOSEPH ROSELLI JR. DPT

NPI Number: 1649946401
Health Care Provider/Practitioner: JOHN JOSEPH ROSELLI JR. DPT

Information about “1649946401” NPI (JOHN JOSEPH ROSELLI JR. DPT) exists in 1649946401 in HTML format HTML  |  1649946401 in plain Text format TXT  |  1649946401 in PDF (Portable Document Format) PDF  |  1649946401 in an XML format XML  formats.

NPI Number : 1649946401 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649946401",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROSELLI",
    "FirstName": "JOHN",
    "MiddleName": "JOSEPH",
    "NamePrefix": null,
    "NameSuffix": "JR.",
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROSELLI",
    "OtherFirstName": "JOHN",
    "OtherMiddleName": "JOSEPH",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": "JR.",
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "601 PATTON BLVD APT 406",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLANO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75075-8975",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-512-4887",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4430 LAVON DR STE 340",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GARLAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75040-2974",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-495-5416",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/20/2021",
    "LastUpdateDate": "08/20/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1352417",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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