Provider Demographics
NPI:1881602118
Name:WASSERMAN, ROSALYN (LPT)
Entity type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15294
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0294
Mailing Address - Country:US
Mailing Address - Phone:828-665-0442
Mailing Address - Fax:828-665-0412
Practice Address - Street 1:323 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4311
Practice Address - Country:US
Practice Address - Phone:828-698-3489
Practice Address - Fax:828-698-3490
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9551174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC06703OtherBC/BS
NC06703OtherBC/BS