Provider Demographics
NPI:1629628524
Name:ROSINTOSKI, MELISSA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:ROSINTOSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22851 COUNTY ROUTE 144
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:13612-3176
Mailing Address - Country:US
Mailing Address - Phone:315-777-6694
Mailing Address - Fax:
Practice Address - Street 1:4016 CASSIMER AVE
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-2309
Practice Address - Country:US
Practice Address - Phone:228-280-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT6793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist