Provider Demographics
NPI:1629172259
Name:LENT, ROSANNE MARIE (RPT)
Entity Type:Individual
Prefix:MS
First Name:ROSANNE
Middle Name:MARIE
Last Name:LENT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:1814 NYS RTE 73
Mailing Address - City:KEENE VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12943
Mailing Address - Country:US
Mailing Address - Phone:518-576-9243
Mailing Address - Fax:
Practice Address - Street 1:10 ST PATRICK PLACE
Practice Address - Street 2:MOUNTAINLAKE SERV
Practice Address - City:PORT HENRY
Practice Address - State:NY
Practice Address - Zip Code:12974
Practice Address - Country:US
Practice Address - Phone:518-546-3801
Practice Address - Fax:518-546-3785
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist