Provider Demographics
NPI:1730119108
Name:DOOLEY, ROSANNA F (PA)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:F
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5952
Mailing Address - Country:US
Mailing Address - Phone:504-891-8111
Mailing Address - Fax:281-460-2529
Practice Address - Street 1:1015 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5952
Practice Address - Country:US
Practice Address - Phone:504-891-8111
Practice Address - Fax:281-460-2529
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02113363AM0700X
LAPA.200176363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89N443OtherBCBS
TX970025360OtherRAILROAD MEDICARE
TX970025360OtherRAILROAD MEDICARE
TX87N484Medicare ID - Type Unspecified