Provider Demographics
NPI:1629116371
Name:ROSENFELD, DAVID N (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 ACKERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4200
Mailing Address - Country:US
Mailing Address - Phone:201-447-5630
Mailing Address - Fax:201-447-0903
Practice Address - Street 1:265 ACKERMAN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4200
Practice Address - Country:US
Practice Address - Phone:201-447-5630
Practice Address - Fax:201-447-0903
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 0543702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260029593Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJE62033Medicare UPIN
NJ620554Medicare ID - Type UnspecifiedMEDICARE LEGACY NUMBER