Provider Demographics
NPI:1619483641
Name:DEL ROSARIO, ARJAY ALBERTO (PT)
Entity Type:Individual
Prefix:
First Name:ARJAY ALBERTO
Middle Name:
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17328 NEWLANDS CORNER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2480
Mailing Address - Country:US
Mailing Address - Phone:704-585-7733
Mailing Address - Fax:704-585-7733
Practice Address - Street 1:17328 NEWLANDS CORNER LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2480
Practice Address - Country:US
Practice Address - Phone:704-585-7733
Practice Address - Fax:704-585-7733
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP14574OtherNC PT LICENSE