Provider Demographics
NPI:1326486408
Name:ROSENBAUM-ROLLER, SHIRA R (CNM)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:R
Last Name:ROSENBAUM-ROLLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1633
Mailing Address - Country:US
Mailing Address - Phone:917-683-3613
Mailing Address - Fax:
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:BUILDING 800, SUITE 122
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-770-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife