Provider Demographics
NPI:1821572116
Name:ADAN, ROSALIA ESMERALDA
Entity Type:Individual
Prefix:
First Name:ROSALIA
Middle Name:ESMERALDA
Last Name:ADAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2122
Mailing Address - Country:US
Mailing Address - Phone:267-770-0645
Mailing Address - Fax:
Practice Address - Street 1:440 POPLAR ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2122
Practice Address - Country:US
Practice Address - Phone:267-770-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN710335163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health