Provider Demographics
NPI:1982216313
Name:ROSENBERG, DEVON ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:DEVON
Middle Name:ELIZABETH
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:DEVON
Other - Middle Name:ELIZABETH
Other - Last Name:SCALISE-FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2265 MARKET ST.
Mailing Address - Street 2:STE A
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-4682
Mailing Address - Country:US
Mailing Address - Phone:814-726-9050
Mailing Address - Fax:814-726-9629
Practice Address - Street 1:2265 MARKET ST.
Practice Address - Street 2:STE A
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-4682
Practice Address - Country:US
Practice Address - Phone:814-726-9050
Practice Address - Fax:814-726-9629
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038558690001Medicaid