Provider Demographics
NPI:1770797953
Name:ROSAMILIA, LORRAINE (MD)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:ROSAMILIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BROOKHILL SQUARE SOUTH
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF
Mailing Address - State:PA
Mailing Address - Zip Code:18249-1010
Mailing Address - Country:US
Mailing Address - Phone:570-459-0029
Mailing Address - Fax:570-454-5757
Practice Address - Street 1:8 BROOKHILL SQUARE SOUTH
Practice Address - Street 2:
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249-1010
Practice Address - Country:US
Practice Address - Phone:570-459-0029
Practice Address - Fax:570-454-5757
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186384207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology