Provider Demographics
NPI:1871148205
Name:ROSINSKY, MATHEW
Entity type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:
Last Name:ROSINSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BEAU DR
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-3202
Mailing Address - Country:US
Mailing Address - Phone:724-630-3236
Mailing Address - Fax:
Practice Address - Street 1:99 ERIE ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2201
Practice Address - Country:US
Practice Address - Phone:814-734-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0421991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice