Provider Demographics
NPI:1801334974
Name:ROSETTE, VICENTE V DEMETRI II
Entity type:Individual
Prefix:MR
First Name:VICENTE
Middle Name:V DEMETRI
Last Name:ROSETTE
Suffix:II
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 1:1020 ADAMS AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6689
Mailing Address - Country:US
Mailing Address - Phone:207-844-4486
Mailing Address - Fax:
Practice Address - Street 1:1020 ADAMS AVE APT 2C
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6689
Practice Address - Country:US
Practice Address - Phone:207-844-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer