Provider Demographics
NPI:1336101807
Name:ROSATI, ADAM R JR (OD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:ROSATI
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 8TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1883
Mailing Address - Country:US
Mailing Address - Phone:610-691-3335
Mailing Address - Fax:691-974-9950
Practice Address - Street 1:5201 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9113
Practice Address - Country:US
Practice Address - Phone:610-530-4444
Practice Address - Fax:610-366-1343
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAHL2833746152W00000X
PAOEG000927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30205Medicare UPIN
PA405869JKDMedicare PIN