Provider Demographics
NPI:1508080128
Name:ROSENBAUM, HOWARD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:S
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 HILLSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1230
Mailing Address - Country:US
Mailing Address - Phone:201-666-6060
Mailing Address - Fax:
Practice Address - Street 1:817 HILLSDALE AVE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-1230
Practice Address - Country:US
Practice Address - Phone:201-666-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00110200213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist