Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT004071 L | PA |
N | 2251E1200X | Ergonomics | PT004071 L | PA |
N | 225XE1200X | Ergonomics | PT004071 L | PA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT004071 L | PA |
N | 2251H1200X | Hand | PT004071 L | PA |
N | 2251H1300X | Human Factors | PT004071 L | PA |
N | 225XH1300X | Human Factors | PT004071 L | PA |
N | 2251N0400X | Physical Therapist - Neurology | PT004071 L | PA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT004071 L | PA |
N | 2251S0007X | Physical Therapist - Sports | PT004071 L | PA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT004071 L | PA |
N | 225400000X | Rehabilitation Practitioner | PT004071 L | PA |
NPI | 1316921331 |
---|---|
Provider Name | Juan Rosario |
First Address | Dickson City, PA 18519-1677 |
Second Address | Dickson City, PA 18519-1677 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012397620007 | (05) | PA |
163627 | MEDPLUS (01) | PA |
3302361 | AETNA HMO (01) | PA |
5868017 | AETNA PPO (01) | PA |
677615 | HIGHMARK (01) | PA |
819329 | FIRST PRIORITY/BC/BS (01) | PA |
9384447 | PHCS (01) | PA |