MEDICARE: MISS SARAH MELISSA ROSSI DPT

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	2251X0800X	Orthopedic Physical Therapist	40QA01289400	NJ

General Provider Information

NPI Number	:	1528350394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARAH MELISSA ROSSI DPT

Provider Business Mailing Address
First Line	:	1372 ROUTE 9
Second Line	:	BUILDING # 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-4038
Country	:	US
Telephone Number	:	732-240-9296
Fax Number	:	732-240-9297

Provider Business Practice Location Address
First Line	:	1372 ROUTE 9
Second Line	:	BUILDING # 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-4038
Country	:	US
Telephone Number	:	732-240-9296
Fax Number	:	732-240-9297

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

Provider Enumeration Date	:	05/11/2011
Last Update Date	:	12/27/2011

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