Provider Demographics
NPI:1831853860
Name:ROSELLI, SARAH MADISON (OTR/L; EMT-B)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MADISON
Last Name:ROSELLI
Suffix:
Gender:F
Credentials:OTR/L; EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TENNIS PL
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2425
Mailing Address - Country:US
Mailing Address - Phone:973-477-9573
Mailing Address - Fax:
Practice Address - Street 1:18 TENNIS PL
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2425
Practice Address - Country:US
Practice Address - Phone:973-477-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01007600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist