Provider Demographics
NPI:1356426126
Name:ROSENBERG, STUART O (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:O
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 WINTHROP RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3020
Mailing Address - Country:US
Mailing Address - Phone:866-633-8255
Mailing Address - Fax:718-405-8278
Practice Address - Street 1:MONTEFIORE MEDICAL PARK
Practice Address - Street 2:1575 BLONDELL AVENUE, STE. 220
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:866-633-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169857207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology