Provider Demographics
NPI:1932589454
Name:ROXAS, ROSELYN A (PT)
Entity Type:Individual
Prefix:
First Name:ROSELYN
Middle Name:A
Last Name:ROXAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ROSELYN
Other - Middle Name:ARROJADO
Other - Last Name:ROXAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:113 ROUTE 73
Mailing Address - Street 2:VOORHEES
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9573
Mailing Address - Country:US
Mailing Address - Phone:856-809-3559
Mailing Address - Fax:856-809-3573
Practice Address - Street 1:2601 E EVESHAM RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9509
Practice Address - Country:US
Practice Address - Phone:856-482-4451
Practice Address - Fax:856-985-8365
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00500100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJR6904 67161 55622OtherNJ DRIVER'S LICENSE NO.