Individual ProviderTricia Ann RosarioPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address215 Hallock Road, Suite 5, Stony Brook, NY 11790(631) 689-6666PECOS EnrollmentBased on the most recent information from CMS, provider Tricia Ann Rosario does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1417024712Provider TypeIndividualFull NameRosario, Tricia AnnTitleMs.CredentialMSPTGenderFemaleSole ProprietorNoEnumeration Date11/29/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address215 Hallock Road, Suite 5, Stony Brook, NY 11790Phone(631) 689-6666Fax(631) 689-6668Mailing LocationMailing Address215 Hallock Road, Suite 5, Stony Brook, NY 11790Phone(631) 689-6666Fax(631) 689-6668Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense0213871New YorkProvider IdentifiersIDDescriptionIssuerID111449DescriptionOtherIssuerVYTRAID3940254DescriptionOtherIssuerAETNA HMOID43210DescriptionOtherIssuerCIGNA HMO ORTHONETID6697152DescriptionOtherIssuerGHI PPOID87966DescriptionOtherIssuerGHI HMOIDXC6679DescriptionOtherIssuerHEALTHNETID20079270DescriptionOtherIssuerISLAND GROUP ADMINISTRATOID0012960456000290DescriptionOtherIssuerDOH RELATED SERVICESID157625PDescriptionOtherIssuerHIPIDA200810DescriptionOtherIssuerMDNYID5607714DescriptionOtherIssuerFIRST HEALTHID4341677DescriptionOtherIssuerCIGNA PROIDQ10N11DescriptionOtherIssuerEMPIRE BLUE CROSS BLUE SH