Provider Demographics
NPI:1952395766
Name:CESAR, ROSE LAROSITIERE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:LAROSITIERE
Last Name:CESAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:LAROSILIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:48 SANDERSON ST
Practice Address - Street 2:2ND LF
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2778
Practice Address - Country:US
Practice Address - Phone:413-773-2655
Practice Address - Fax:413-772-2629
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78186207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F63922Medicare UPIN
GA10BBCGAMedicare PIN
GAGRP6730Medicare ID - Type Unspecified
GA00867974AMedicaid
MA78186OtherLICENSE
GAF63922Medicare UPIN