Provider Demographics
NPI:1710035928
Name:ROGER G. ROSENSTEIN, MD FREDERICK F. FAKHARZADEH, MD PA
Entity Type:Organization
Organization Name:ROGER G. ROSENSTEIN, MD FREDERICK F. FAKHARZADEH, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-587-7767
Mailing Address - Street 1:22 MADISON AVE
Mailing Address - Street 2:SUITE 3-1
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2734
Mailing Address - Country:US
Mailing Address - Phone:201-587-7767
Mailing Address - Fax:201-587-8090
Practice Address - Street 1:22 MADISON AVE
Practice Address - Street 2:SUITE 3-1
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2734
Practice Address - Country:US
Practice Address - Phone:201-587-7767
Practice Address - Fax:201-587-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty