Provider Demographics
NPI:1275512840
Name:ROSEN, ROBERT MARK (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:ROSEN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:780 ROUTE 37 W
Mailing Address - Street 2:STE 240
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5059
Mailing Address - Country:US
Mailing Address - Phone:732-244-4566
Mailing Address - Fax:732-569-6285
Practice Address - Street 1:780 ROUTE 37 W
Practice Address - Street 2:STE 240
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5059
Practice Address - Country:US
Practice Address - Phone:732-244-4566
Practice Address - Fax:732-569-6285
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2020-10-04
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Provider Licenses
StateLicense IDTaxonomies
NJMB056943207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC4433Medicare UPIN
NJRO687619Medicare PIN