Individual
CIEARA ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 W LEHIGH AVE, PHILADELPHIA, PA 19132-2652
(484) 270-6200
Mailing address
1944 74TH AVE, PHILADELPHIA, PA 19138-2221
(607) 331-9066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00892000
NJ
363A00000X
Physician Assistant
MA066182
PA
Other
Enumeration date
10/29/2024
Last updated
04/02/2026
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