Provider Demographics
NPI:1043383995
Name:ROSENDORF, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:ROSENDORF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 MCBRIDE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-3806
Mailing Address - Country:US
Mailing Address - Phone:973-812-1400
Mailing Address - Fax:973-812-1404
Practice Address - Street 1:130 KINDERKAMACK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1939
Practice Address - Country:US
Practice Address - Phone:201-489-7772
Practice Address - Fax:201-489-2544
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07335100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0072711Medicaid