Provider Demographics
NPI:1093147100
Name:ROSENBERGER, KATHRYN P (RN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:P
Last Name:ROSENBERGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 AIRPORT EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5238
Mailing Address - Country:US
Mailing Address - Phone:845-425-2655
Mailing Address - Fax:
Practice Address - Street 1:508 AIRPORT EXECUTIVE PARK
Practice Address - Street 2:19 COURT ST.SUITE 206 WHITE PLAINS NY
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5238
Practice Address - Country:US
Practice Address - Phone:845-425-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237300163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health