Provider Demographics
NPI:1508548777
Name:ATKINSON, ROSALIE DIANA (BA, MBA, MHA, DBA IN)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:DIANA
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:BA, MBA, MHA, DBA IN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3417
Mailing Address - Country:US
Mailing Address - Phone:201-638-1581
Mailing Address - Fax:
Practice Address - Street 1:115 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-3417
Practice Address - Country:US
Practice Address - Phone:201-638-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities