Provider Demographics
NPI:1720602451
Name:ROSENGART, JENA (MSED)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:ROSENGART
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2062 ILLONA LN
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5427
Mailing Address - Country:US
Mailing Address - Phone:347-751-3539
Mailing Address - Fax:
Practice Address - Street 1:2062 ILLONA LN
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5427
Practice Address - Country:US
Practice Address - Phone:347-751-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist