Provider Demographics
NPI:1073910519
Name:GORMAN, ROSEMARY D (APN)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:D
Last Name:GORMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 RUTLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4702
Mailing Address - Country:US
Mailing Address - Phone:732-687-7632
Mailing Address - Fax:732-796-7123
Practice Address - Street 1:205 RUTLEDGE DR
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-4702
Practice Address - Country:US
Practice Address - Phone:732-687-7632
Practice Address - Fax:732-796-7123
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00537700207RH0002X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health