Provider Demographics
NPI:1679655419
Name:MICHAEL, ROSITTA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSITTA
Middle Name:
Last Name:MICHAEL
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 1:2100 WESCOTT DR FL 4
Mailing Address - Street 2:(PEDIATRIC HOSPITALIST)
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4603
Mailing Address - Country:US
Mailing Address - Phone:908-788-6100
Mailing Address - Fax:
Practice Address - Street 1:2100 WESCOTT DR FL 4
Practice Address - Street 2:(PEDIATRIC HOSPITALIST)
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-788-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO7770500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4136900Medicaid
NJI20874Medicare UPIN
NJ085232B3LMedicare ID - Type Unspecified