Rosadel Diaz

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12385 Issued in CT

Practice address

82 New Park Ave
North Franklin, CT 06254-1807

Phone

(860) 885-7223

NPI assigned

Aug 16, 2019

Last updated

Aug 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1649826439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 NEW PARK AVE",
            "city": "NORTH FRANKLIN",
            "state": "CT",
            "postal_code": "062541807",
            "telephone_number": "860-885-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 NEW PARK AVE",
            "city": "NORTH FRANKLIN",
            "state": "CT",
            "postal_code": "062541807",
            "telephone_number": "860-885-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Industrial Park Rd",
            "address_purpose": "LOCATION",
            "city": "Niantic",
            "state": "CT",
            "postal_code": "063571904",
            "country_code": "US",
            "telephone_number": "860-885-7223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ROSADEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "C00123",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004002358",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Collelo
• Adem Lutfi Cosgel, PA-C
• Jennifer Davis-Muller, NCC, LPC
• Laura Caroline Dawson, LCSW
• Kelsey Welsh Depriest, PA-C
• Holly Elizabeth Dreger, LCSW
• Richard E Drena, MSLADC
• Kaitlin A Dunn, DPT
• Okechuku Chukwudi Ekwuabu Jr., DPT
• David Lawrence Farrington, PA

• Physical Therapist in North Franklin, CT
• Providers in North Franklin, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.