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NPI Code Detail

MEDICARE: MRS. DIANA M ROSAS

MEDICARE: MRS. DIANA M ROSAS
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
1225100000XPhysical Therapist40QA00485600NJ

General Provider Information

NPI Number : 1952501512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANA M ROSAS
Provider Business Mailing Address
First Line : 455 CECELIA AVE
Second Line :
City : CLIFFSIDE PARK
State : NJ
Zip : 07010-2822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9020 WALL ST
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-6011
Country : US
Telephone Number : 201-809-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2007
Last Update Date : 07/23/2007

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Directions to “ MRS. DIANA M ROSAS ” Practice Location

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