Provider Demographics
NPI:1316921331
Name:ROSARIO, JUAN (PT)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:851 COMMERCE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1677
Mailing Address - Country:US
Mailing Address - Phone:570-489-5561
Mailing Address - Fax:570-489-5563
Practice Address - Street 1:851 COMMERCE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1677
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:570-489-5563
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT004071 L225100000X, 2251E1200X, 2251G0304X, 2251H1200X, 2251H1300X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012397620007Medicaid
PA819329OtherFIRST PRIORITY/BC/BS
PA163627OtherMEDPLUS
PA3302361OtherAETNA HMO
PA5868017OtherAETNA PPO
PA677615OtherHIGHMARK
PA9384447OtherPHCS