Provider Demographics
NPI:1851410021
Name:ROSA, SCOTT L (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:ROSA
Suffix:
Gender:M
Credentials:DC
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 437
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:NY
Mailing Address - Zip Code:12775-0437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ROCKHILL DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKHILL
Practice Address - State:NY
Practice Address - Zip Code:12775-0000
Practice Address - Country:US
Practice Address - Phone:845-796-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005404-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX34671Medicare PIN