Provider Demographics
NPI:1366465486
Name:ROSENBERG, DANIEL STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STUART
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SCOTCH ROAD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-0845
Mailing Address - Country:US
Mailing Address - Phone:609-883-0614
Mailing Address - Fax:609-883-1606
Practice Address - Street 1:34 SCOTCH ROAD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-0845
Practice Address - Country:US
Practice Address - Phone:609-883-0614
Practice Address - Fax:609-883-1606
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA446232081P2900X
PAME040291E2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098161OtherCIGNA
PA235129700OtherKEYSTONE
PA1675152OtherINDEPENDENCE BC
PA0411768000OtherAMERIHEALTH
NJ4550143OtherAETNA
NJHEALTHNETOtherOK1493
NJOXFORDOtherP647922
NJ098161OtherCIGNA
PA1675152OtherINDEPENDENCE BC
NJHEALTHNETOtherOK1493
NJ4550143OtherAETNA