Provider Demographics
NPI:1154847556
Name:ROSANIA, JAY JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:JAMES
Last Name:ROSANIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CATHEDRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2521
Mailing Address - Country:US
Mailing Address - Phone:201-953-9464
Mailing Address - Fax:
Practice Address - Street 1:507 UNION AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2215
Practice Address - Country:US
Practice Address - Phone:973-751-9372
Practice Address - Fax:973-751-6087
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01747200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist