Provider Demographics
NPI:1790700698
Name:ROSEFF, SHARI (DC)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:
Last Name:ROSEFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3266
Mailing Address - Country:US
Mailing Address - Phone:732-370-9200
Mailing Address - Fax:732-370-4350
Practice Address - Street 1:301 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3266
Practice Address - Country:US
Practice Address - Phone:732-370-9200
Practice Address - Fax:732-370-4350
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00424200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1790700698OtherMEDICARE
NJ39487239OtherTRAID
NJP469593OtherOXFORD HEALTH PLANS
NJ10061OtherAMERIGROUP
NJ5899928OtherGHI