Provider Demographics
NPI:1609969625
Name:COVALESKY, ROSE MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:COVALESKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 N BROAD ST
Mailing Address - Street 2:3RD FLR CARDIOLOGY CONSULTANTS OF PHILA
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-462-7100
Mailing Address - Fax:215-463-3820
Practice Address - Street 1:1703 S BROAD ST
Practice Address - Street 2:STE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-1536
Practice Address - Country:US
Practice Address - Phone:215-463-5353
Practice Address - Fax:215-463-8085
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2017-04-25
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Provider Licenses
StateLicense IDTaxonomies
PAMA002765L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA002765LOtherLICENSE #