Provider Demographics
NPI:1063474864
Name:ROSADO, SULANG (MD)
Entity Type:Individual
Prefix:
First Name:SULANG
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:12 ST PAUL DR STE 207
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1035
Practice Address - Country:US
Practice Address - Phone:717-217-6882
Practice Address - Fax:717-217-6883
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93807207V00000X
PAMD423743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1559302OtherGATEWAY
PA25-1716306OtherINTERGROUP
PA1007307260034OtherMEDICAID GROUP #
FL273592000Medicaid
PA531092OtherHEALTH AMERICA
PAP00458410OtherRAILROAD MEDICARE
PARO1923147OtherHIGHMARK BLUESHIELD
PA2157766OtherMAMSI
PA1466979OtherAETNA HMO
PA25-1716306OtherINFORMED
PA201712OtherUNISON
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA50065190OtherCAPITAL BLUECROSS
PA5662562OtherFIRST HEALTH
PA7386741OtherAETNA NON-HMO
PAG920-0062/KV77CUOtherCAREFIRST
PA25-1716306OtherHEALTHNET/TRICARE
PA120420413OtherDEPT OF LABOR
PA867633OtherMEDICARE GROUP #
PAMD423743OtherLICENSE
PA1017833300001Medicaid
PA25-1716306OtherDEVON
PA25-1716306OtherDEVON
FLI40998Medicare UPIN
PA1007307260034OtherMEDICAID GROUP #
PA50065190OtherCAPITAL BLUECROSS
PA531092OtherHEALTH AMERICA