Provider Demographics
NPI:1154324291
Name:ROSANIA, ANTHONY A (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:A
Last Name:ROSANIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 ROUTE 9
Mailing Address - Street 2:STORE 4
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3714
Mailing Address - Country:US
Mailing Address - Phone:973-768-5100
Mailing Address - Fax:
Practice Address - Street 1:2225 ROUTE 9
Practice Address - Street 2:STORE 4
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3714
Practice Address - Country:US
Practice Address - Phone:973-768-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00584600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU95204Medicare UPIN