Provider Demographics
NPI:1013133669
Name:ROSSANO, SANGITA (PA - C)
Entity Type:Individual
Prefix:MRS
First Name:SANGITA
Middle Name:
Last Name:ROSSANO
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3737
Mailing Address - Country:US
Mailing Address - Phone:973-736-9300
Mailing Address - Fax:973-736-9328
Practice Address - Street 1:101 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 405
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1000
Practice Address - Country:US
Practice Address - Phone:973-736-9300
Practice Address - Fax:973-736-9328
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00039400363A00000X
NY009254-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant