Provider Demographics
NPI:1457685216
Name:SHAW, ROSITA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ROSITA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ROSIE
Other - Middle Name:
Other - Last Name:PICCIRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5157 EUSTON CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2333
Mailing Address - Country:US
Mailing Address - Phone:215-447-8227
Mailing Address - Fax:
Practice Address - Street 1:5157 EUSTON CT
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2333
Practice Address - Country:US
Practice Address - Phone:215-447-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor