Provider Demographics
NPI:1598340549
Name:ROXANNE ROSENBERG, PLLC
Entity Type:Organization
Organization Name:ROXANNE ROSENBERG, PLLC
Other - Org Name:ROSENBERG PERINATAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-694-7116
Mailing Address - Street 1:6120 SAINT GILES ST STE 240
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7046
Mailing Address - Country:US
Mailing Address - Phone:919-694-7116
Mailing Address - Fax:
Practice Address - Street 1:6120 SAINT GILES ST STE 240
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7046
Practice Address - Country:US
Practice Address - Phone:919-694-7116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty