Provider Demographics
NPI:1639493042
Name:VICTOR I. ROSENBERG, M.D., P.C.
Entity Type:Organization
Organization Name:VICTOR I. ROSENBERG, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:I
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-383-5497
Mailing Address - Street 1:54 BROAD ST
Mailing Address - Street 2:SUITE L105
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1943
Mailing Address - Country:US
Mailing Address - Phone:732-383-5497
Mailing Address - Fax:732-383-5532
Practice Address - Street 1:54 BROAD ST
Practice Address - Street 2:SUITE L105
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1943
Practice Address - Country:US
Practice Address - Phone:732-383-5497
Practice Address - Fax:732-383-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08708300208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty