Provider Demographics
NPI:1609027374
Name:ROSENTHAL, ROBYN KUSCHKE (EDS)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:KUSCHKE
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3504
Mailing Address - Country:US
Mailing Address - Phone:908-642-6233
Mailing Address - Fax:908-725-9121
Practice Address - Street 1:265 MILLER AVE
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3504
Practice Address - Country:US
Practice Address - Phone:908-642-6233
Practice Address - Fax:908-725-9121
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00314100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0161446Medicaid