Provider Demographics
NPI:1124230578
Name:ROSADO, ANNETTE LEE (APN)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:LEE
Last Name:ROSADO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:ANNETTE
Other - Middle Name:LEE
Other - Last Name:ROSADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN-C
Mailing Address - Street 1:10 HIGHLAND AVE
Mailing Address - Street 2:APT 7
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1261
Mailing Address - Country:US
Mailing Address - Phone:973-972-2987
Mailing Address - Fax:
Practice Address - Street 1:150 BERGEN ST
Practice Address - Street 2:MEZZANINE 218
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00056300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health