| Doctor Name: | MRS. ROSEMARY TAKACS |
| NPI Number: | 1588080782 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BS, CDE |
| License Number: | RN-199951-L |
| Business Practice Address: | 200 Main St Suite L 4 Blakely, PA - 184471241 |
| Business Phone Number: | 5706046677 |
| Business Fax Number: | 5703074220 |
| Mailing Address: | 200 Main St, Suite L 4 BLAKELY |
| State: | PA |
| Postal Code: | 184471241 |
| Phone Number: | 5706046677 |
| Fax Number: | 5703074220 |
| NPI Enumeration Date: | 03/12/2014 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | RN-199951-L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |