Provider Demographics
NPI:1245232677
Name:ROSENFELD, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 ROUTE 27
Mailing Address - Street 2:PINES PLAZA
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3372
Mailing Address - Country:US
Mailing Address - Phone:732-287-6663
Mailing Address - Fax:732-287-6664
Practice Address - Street 1:2090 ROUTE 27
Practice Address - Street 2:PINES PLAZA
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3372
Practice Address - Country:US
Practice Address - Phone:732-287-6663
Practice Address - Fax:732-287-6664
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04817100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0527315000OtherAMERIHEALTH #
NJ5614705OtherAETNA PPO #
NJP00976719OtherRR MCR
NJP735790OtherOXFORD #
NJ110230392OtherRR MDCR #
NJ0K3398OtherHEALTHNET #
NJ917371OtherEMPIRE BC/BS #
NJ2056402Medicaid
NJ2069917OtherAETNA HMO #
NJ210749OtherUNIFORMED SERVICES
NJ223586872OtherTAX IDENTIFICATION #
NJ18083OtherUNIVERSITY HEALTH PLANS #
NJ2900493OtherGHI PPO #
NJ917371OtherEMPIRE BC/BS #
NJ5614705OtherAETNA PPO #
NJ210749OtherUNIFORMED SERVICES