| Doctor Name: | DR. WILLIS ANTHONY ROSENA |
| NPI Number: | 1093943235 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 006696 |
| Business Practice Address: | 87 Mead St North Tonawanda, NY - 141204444 |
| Business Phone Number: | 7166921451 |
| Business Fax Number: | 7166921495 |
| Mailing Address: | 87 Mead St, NORTH TONAWANDA |
| State: | NY |
| Postal Code: | 141204444 |
| Phone Number: | 7166921451 |
| Fax Number: | 7166921495 |
| NPI Enumeration Date: | 06/25/2009 |
| NPI Last Update Date: | 04/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 006696 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |