Provider Demographics
NPI:1578668588
Name:ROSOWSKI, JEAN T (AUD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:T
Last Name:ROSOWSKI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CONCORD AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478
Mailing Address - Country:US
Mailing Address - Phone:617-484-8700
Mailing Address - Fax:617-484-3043
Practice Address - Street 1:90 CONCORD AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478
Practice Address - Country:US
Practice Address - Phone:617-484-8700
Practice Address - Fax:617-484-3043
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
797641OtherTUFTS
MA5102359Medicaid
MAAA143249OtherHARVARD PILGRIM HEALTHCARE
4500070OtherUNITED HEALTHCARE
MAAD0062OtherBCBS
797641OtherTUFTS