Organization
JOHN DELLA ROSA, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DELLA ROSA (SOLE PROPRIETOR)
(570) 331-2655
Entity
Organization
Contact information
Practice address
190 WELLES ST, SUITE 114, FORTY FORT, PA 18704-4968
(570) 331-2655
(570) 331-2671
Mailing address
190 WELLES ST, SUITE 114, FORTY FORT, PA 18704-4969
(570) 331-2655
(570) 331-2671
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD030692E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000945585004
—
PA
Enumeration date
06/01/2007
Last updated
08/22/2020
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