Provider Demographics
NPI:1417474347
Name:STANGER, ROSELYN KELLEN (MD)
Entity Type:Individual
Prefix:
First Name:ROSELYN
Middle Name:KELLEN
Last Name:STANGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5536
Mailing Address - Country:US
Mailing Address - Phone:201-566-1806
Mailing Address - Fax:
Practice Address - Street 1:1000 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5536
Practice Address - Country:US
Practice Address - Phone:201-566-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD482735207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology