Provider Demographics
NPI:1144398249
Name:DELA ROSA, MICHELLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:DELA ROSA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3825
Mailing Address - Country:US
Mailing Address - Phone:609-584-4770
Mailing Address - Fax:609-584-4880
Practice Address - Street 1:1675 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3825
Practice Address - Country:US
Practice Address - Phone:609-584-4770
Practice Address - Fax:609-584-4880
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022409225100000X
NJ40QA00944200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist