Provider Demographics
NPI:1689801318
Name:ROSENSTOCK, JESSICA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ROSE
Last Name:ROSENSTOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ROSE
Other - Last Name:GRODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 WASHINGTON ST STE 768
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1645
Mailing Address - Country:US
Mailing Address - Phone:617-332-2345
Mailing Address - Fax:617-332-0435
Practice Address - Street 1:2000 WASHINGTON ST STE 768
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1645
Practice Address - Country:US
Practice Address - Phone:617-332-2345
Practice Address - Fax:617-332-0435
Is Sole Proprietor?:No
Enumeration Date:2009-06-21
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA275154207V00000X
TXP7197207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology