Basic Information
| Provider Information | |||||||||
| NPI: | 1063474864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSADO | ||||||||
| FirstName: | SULANG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 ST PAUL DR STE 207 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172176882 | ||||||||
| FaxNumber: | 7172176883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 03/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME93807 | FL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | MD423743 | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1559302 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 273592000 | 05 | FL | MEDICAID | 531092 | 01 | PA | HEALTH AMERICA | OTHER | P00458410 | 01 | PA | RAILROAD MEDICARE | OTHER | RO1923147 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 2157766 | 01 | PA | MAMSI | OTHER | 1466979 | 01 | PA | AETNA HMO | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 201712 | 01 | PA | UNISON | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 50065190 | 01 | PA | CAPITAL BLUECROSS | OTHER | 5662562 | 01 | PA | FIRST HEALTH | OTHER | 7386741 | 01 | PA | AETNA NON-HMO | OTHER | BR8685111 | 01 | PA | DEA | OTHER | G920-0062/KV77CU | 01 | PA | CAREFIRST | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 120420413 | 01 | PA | DEPT OF LABOR | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | MD423743 | 01 | PA | LICENSE | OTHER | 1017833300001 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | DEVON | OTHER |