Provider Demographics
NPI:1679820112
Name:ROSENBERG, ERICA L (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:L
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11A BEEKMAN PL
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3634
Mailing Address - Country:US
Mailing Address - Phone:201-300-6149
Mailing Address - Fax:
Practice Address - Street 1:11A BEEKMAN PL
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3634
Practice Address - Country:US
Practice Address - Phone:201-300-6149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00369500225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics