Provider Demographics
NPI:1265708051
Name:DEBRA L. ROSENZWEIG, M.D.
Entity type:Organization
Organization Name:DEBRA L. ROSENZWEIG, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-616-9395
Mailing Address - Street 1:2035 HAMBURG TPKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6251
Mailing Address - Country:US
Mailing Address - Phone:973-616-9395
Mailing Address - Fax:973-839-2983
Practice Address - Street 1:2035 HAMBURG TPKE
Practice Address - Street 2:SUITE C
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6251
Practice Address - Country:US
Practice Address - Phone:973-616-9395
Practice Address - Fax:973-839-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65697207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF31602Medicare UPIN