Provider Demographics
NPI:1619079761
Name:ROSENFELD, FRAN (NP)
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GAINSBORO RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1521
Mailing Address - Country:US
Mailing Address - Phone:856-424-6638
Mailing Address - Fax:
Practice Address - Street 1:100 GAINSBORO RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1521
Practice Address - Country:US
Practice Address - Phone:856-424-6638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR250477363LA2200X
NJ26NN09830700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7899807Medicaid
NJ003319ABNMedicare ID - Type Unspecified
NJ7899807Medicaid