Provider Demographics
NPI:1891818746
Name:ROSINGER, JEROME MAURICE (DDS)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:MAURICE
Last Name:ROSINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PARK AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4329
Mailing Address - Country:US
Mailing Address - Phone:212-689-8002
Mailing Address - Fax:212-689-8002
Practice Address - Street 1:16 PARK AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4329
Practice Address - Country:US
Practice Address - Phone:212-689-8002
Practice Address - Fax:212-689-8002
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27126122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist