Provider Demographics
NPI:1093738510
Name:ROSATO, ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:ROSATO
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 1:250 WEST LANCASTER AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-407-9000
Mailing Address - Fax:610-407-9005
Practice Address - Street 1:250 WEST LANCASTER AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-407-9000
Practice Address - Fax:610-407-9005
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-072859-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018744500004Medicaid
PA0018744500004Medicaid
PA054396Medicare ID - Type Unspecified