Provider Demographics
NPI:1366857997
Name:EANG, ROSANNA (DO)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:
Last Name:EANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1865 HARRISON AVE STE 1300
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08105-3660
Mailing Address - Country:US
Mailing Address - Phone:569-630-1268
Mailing Address - Fax:856-365-0279
Practice Address - Street 1:1865 HARRISON AVE STE 1300
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-3660
Practice Address - Country:US
Practice Address - Phone:569-630-1268
Practice Address - Fax:856-365-0279
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09997100207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine