Provider Demographics
NPI:1770609851
Name:ROSENBERG, KATHRYN (CNM)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 143RD ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-5953
Mailing Address - Country:US
Mailing Address - Phone:914-275-8592
Mailing Address - Fax:
Practice Address - Street 1:21 AUDUBON AVE FPC
Practice Address - Street 2:NEW YORK PRESBYTERIAN MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-342-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000250367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife