Provider Demographics
NPI:1205366945
Name:ROSARIO, JUANITA (BIL SPEC ED)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:BIL SPEC ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 TALBOT ST
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3507
Mailing Address - Country:US
Mailing Address - Phone:917-349-6704
Mailing Address - Fax:
Practice Address - Street 1:7238 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2408
Practice Address - Country:US
Practice Address - Phone:718-972-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY901B174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist