Provider Demographics
NPI:1184889453
Name:ROSATO FAMILY EYE CARE LLC
Entity type:Organization
Organization Name:ROSATO FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:TRINAE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSATO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-859-4433
Mailing Address - Street 1:901 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:ALPHA
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-4525
Mailing Address - Country:US
Mailing Address - Phone:908-859-4433
Mailing Address - Fax:908-859-1887
Practice Address - Street 1:901 THIRD AVE
Practice Address - Street 2:
Practice Address - City:ALPHA
Practice Address - State:NJ
Practice Address - Zip Code:08865-4525
Practice Address - Country:US
Practice Address - Phone:908-859-4433
Practice Address - Fax:908-859-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U84436Medicare UPIN