Provider Demographics
NPI:1982148821
Name:ROSOS, FERDINIA BENBINEN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:FERDINIA
Middle Name:BENBINEN
Last Name:ROSOS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:220 OLD COUNTRY RD STOP 1
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4259
Mailing Address - Country:US
Mailing Address - Phone:540-522-2493
Mailing Address - Fax:
Practice Address - Street 1:591 SUMMIT AVE
Practice Address - Street 2:SUITE 413
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:551-225-3449
Practice Address - Fax:551-225-3450
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040030-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist