Provider Demographics
NPI:1437131539
Name:GENEROSE, ROSINA M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSINA
Middle Name:M
Last Name:GENEROSE
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:2 EAST BUTLER DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-2602
Mailing Address - Country:US
Mailing Address - Phone:570-359-3515
Mailing Address - Fax:570-459-5027
Practice Address - Street 1:2 EAST BUTLER DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2602
Practice Address - Country:US
Practice Address - Phone:570-359-3515
Practice Address - Fax:570-459-5027
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC004297L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA805570OtherFIRST PRIORITY HEALTH
PA50001413OtherCAPITAL BLUE CROSS
PAGE956208OtherHIGHMARK BLUE SHIELD
PA50001413OtherCAPITAL BLUE CROSS
PA805570OtherFIRST PRIORITY HEALTH
U66710Medicare UPIN