Provider Demographics
NPI:1619648862
Name:ROSATI, ALLISON J (PTA, RD)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:J
Last Name:ROSATI
Suffix:
Gender:F
Credentials:PTA, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 BAY DALE CT
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2312
Mailing Address - Country:US
Mailing Address - Phone:443-867-0897
Mailing Address - Fax:
Practice Address - Street 1:2564 RIVA RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7405
Practice Address - Country:US
Practice Address - Phone:410-266-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5545225200000X
MDDX6724133V00000X
KS3149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant