Provider Demographics
NPI:1629304498
Name:ROSE-TRZASKA, CAROL ANN (CNM)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:ROSE-TRZASKA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1018
Mailing Address - Country:US
Mailing Address - Phone:732-291-1525
Mailing Address - Fax:
Practice Address - Street 1:70 W BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4016
Practice Address - Country:US
Practice Address - Phone:718-716-2229
Practice Address - Fax:718-228-7471
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00021000367A00000X
NY000326367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife