Provider Demographics
NPI:1083667000
Name:ROSCHER, ATILIO R (MD)
Entity Type:Individual
Prefix:DR
First Name:ATILIO
Middle Name:R
Last Name:ROSCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3813 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2914
Mailing Address - Country:US
Mailing Address - Phone:610-252-9708
Mailing Address - Fax:
Practice Address - Street 1:185 ROSEBERRY ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1690
Practice Address - Country:US
Practice Address - Phone:908-859-6700
Practice Address - Fax:908-859-6812
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA045635207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3695000Medicaid