Provider Demographics
NPI:1629045539
Name:ROSENBERG HENICK, ARLENE MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:MICHELE
Last Name:ROSENBERG HENICK
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 1:301 BRIDGE PLZ N
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5059
Mailing Address - Country:US
Mailing Address - Phone:201-941-0562
Mailing Address - Fax:201-947-5507
Practice Address - Street 1:301 BRIDGE PLZ N
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5059
Practice Address - Country:US
Practice Address - Phone:201-941-0562
Practice Address - Fax:201-947-5507
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05707900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF94197Medicare UPIN
NJHE544228Medicare ID - Type Unspecified