Provider Demographics
NPI:1538565791
Name:ROSADO, MABEL
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 OSGOOD ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5411
Mailing Address - Country:US
Mailing Address - Phone:978-475-3806
Mailing Address - Fax:978-475-6288
Practice Address - Street 1:32 OSGOOD ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-5411
Practice Address - Country:US
Practice Address - Phone:978-475-3806
Practice Address - Fax:978-475-6288
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2283764163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse