Provider Demographics
NPI:1952574675
Name:AQUILIZAN, ROSE MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:ROSE MARIE
Middle Name:
Last Name:AQUILIZAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ROARING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2239
Mailing Address - Country:US
Mailing Address - Phone:413-212-4678
Mailing Address - Fax:
Practice Address - Street 1:148 MAPLE AVE
Practice Address - Street 2:GREAT BARRINGTON REHABILITATION AND NURSING CENTER
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1906
Practice Address - Country:US
Practice Address - Phone:413-528-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist