Individual provider Active NPI

Rowena Perez Dela Rosa

  • Physical Therapist
  • Sodus, NY
National Provider Identifier
1346491875
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015311-1 Issued in NY
Practice address
6884 Maple Avenue
Sodus, NY 14551
Phone
(315) 483-2000
NPI assigned
Oct 2, 2008
Last updated
Oct 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 015311-1 NY Primary

Addresses

Primary practice location

6884 Maple Avenue
Sodus, NY 14551

Mailing address

19 Watersong Trail
Webster, NY 14580
Phone (585) 671-0929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
015311-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1346491875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WATERSONG TRAIL",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "14580",
            "telephone_number": "585-671-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6884 MAPLE AVENUE",
            "city": "SODUS",
            "state": "NY",
            "postal_code": "14551",
            "telephone_number": "315-483-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA ROSA",
        "first_name": "ROWENA",
        "middle_name": "PEREZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015311-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sodus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.