Provider Demographics
NPI:1710379268
Name:ROSENSTEIN, JENNIFER (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:ROSENSTEIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 DARI DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4327
Mailing Address - Country:US
Mailing Address - Phone:631-419-6322
Mailing Address - Fax:
Practice Address - Street 1:160 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-3126
Practice Address - Country:US
Practice Address - Phone:631-589-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305831363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health