Provider Demographics
NPI:1356734206
Name:ROSADO, NAIDA R
Entity type:Individual
Prefix:MRS
First Name:NAIDA
Middle Name:R
Last Name:ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NAIDA
Other - Middle Name:R
Other - Last Name:RODRIGUEZ-ROSADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ZIN, NETA
Mailing Address - Street 1:188 FABER AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-1832
Mailing Address - Country:US
Mailing Address - Phone:203-721-0349
Mailing Address - Fax:
Practice Address - Street 1:188 FABER AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-1832
Practice Address - Country:US
Practice Address - Phone:203-721-0349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator