Provider Demographics
NPI:1659668846
Name:ROSENMAN, JEFFREY SCOTT (DPM, MSCB)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ROSENMAN
Suffix:
Gender:M
Credentials:DPM, MSCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HADDONFIELD BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1412
Mailing Address - Country:US
Mailing Address - Phone:856-429-5100
Mailing Address - Fax:856-429-5800
Practice Address - Street 1:303 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1412
Practice Address - Country:US
Practice Address - Phone:856-429-5100
Practice Address - Fax:856-429-5800
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00322000213E00000X
PAN/A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist