Provider Demographics
NPI:1316537517
Name:SAMUEL J ROSENBERG, D.O. P.C.
Entity Type:Organization
Organization Name:SAMUEL J ROSENBERG, D.O. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:848-525-5346
Mailing Address - Street 1:3 GLADWYNE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1605
Mailing Address - Country:US
Mailing Address - Phone:848-525-5346
Mailing Address - Fax:
Practice Address - Street 1:3 GLADWYNE CT
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1605
Practice Address - Country:US
Practice Address - Phone:848-525-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty