Provider Demographics
NPI:1760401210
Name:ROSENBERG, JESS HOWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JESS
Middle Name:HOWARD
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1412
Mailing Address - Country:US
Mailing Address - Phone:609-585-9222
Mailing Address - Fax:609-581-8097
Practice Address - Street 1:320 WHITE HORSE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1412
Practice Address - Country:US
Practice Address - Phone:609-585-9222
Practice Address - Fax:609-581-8097
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor