Provider Demographics
NPI:1760585285
Name:ROSATI, PATRICIA A (ANP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:ROSATI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5932
Mailing Address - Country:US
Mailing Address - Phone:315-733-1148
Mailing Address - Fax:315-733-0985
Practice Address - Street 1:2115 GENESEE STREET
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5932
Practice Address - Country:US
Practice Address - Phone:315-733-1148
Practice Address - Fax:315-733-0985
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3023561207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00966463Medicaid
BA1161Medicare PIN
NY00966463Medicaid