Provider Demographics
NPI:1952621500
Name:ROSATO, DONALD J
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:ROSATO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 E CONESTOGA RD
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1211
Mailing Address - Country:US
Mailing Address - Phone:610-688-1184
Mailing Address - Fax:
Practice Address - Street 1:176 E CONESTOGA RD
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1211
Practice Address - Country:US
Practice Address - Phone:610-688-1184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-06
Last Update Date:2010-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027413L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine