Provider Demographics
NPI:1265471577
Name:ROSENZWEIG, STACEY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ANN
Last Name:ROSENZWEIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:135 CHESTNUT RIDGE ROAD
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645
Mailing Address - Country:US
Mailing Address - Phone:201-391-2020
Mailing Address - Fax:201-391-0265
Practice Address - Street 1:135 CHESTNUT RIDGE ROAD
Practice Address - Street 2:SUITE 1120
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645
Practice Address - Country:US
Practice Address - Phone:201-391-2020
Practice Address - Fax:201-391-0265
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66336208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics