MEDICARE: MRS. YOLANDA ROSERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		MA

General Provider Information

NPI Number	:	1104381169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YOLANDA ROSERO

Provider Business Mailing Address
First Line	:	21 HARTWELL PL
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-3607
Country	:	US
Telephone Number	:	617-319-1458
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 HARTWELL PL
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-3607
Country	:	US
Telephone Number	:	617-319-1458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2019
Last Update Date	:	02/04/2019

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Directions to “ MRS. YOLANDA ROSERO ” Practice Location

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