Provider Demographics
NPI:1689747875
Name:ROSENBERG, ANNE LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LOUISE
Last Name:ROSENBERG
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 1:1333 HAINESPORT MOUNT LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9522
Mailing Address - Country:US
Mailing Address - Phone:609-519-8289
Mailing Address - Fax:
Practice Address - Street 1:51 HADDONFIELD RD
Practice Address - Street 2:SUITE 145
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4801
Practice Address - Country:US
Practice Address - Phone:856-488-4224
Practice Address - Fax:856-488-8050
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA045066002086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC32871Medicare UPIN