Provider Demographics
NPI:1396003133
Name:ROSARITO, ALEJANDRO F JR
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:F
Last Name:ROSARITO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 47TH AVE
Mailing Address - Street 2:SUITE 2120 D
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3013
Mailing Address - Country:US
Mailing Address - Phone:718-593-4121
Mailing Address - Fax:
Practice Address - Street 1:3310 QUEENS BLVD
Practice Address - Street 2:301
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2302
Practice Address - Country:US
Practice Address - Phone:718-593-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019726225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist