Provider Demographics
NPI:1932418126
Name:ROSENSTEIN, AVISHAI (DPT)
Entity Type:Individual
Prefix:
First Name:AVISHAI
Middle Name:
Last Name:ROSENSTEIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 OLD HOOK RD
Mailing Address - Street 2:SUITE G-01
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3246
Mailing Address - Country:US
Mailing Address - Phone:201-594-9312
Mailing Address - Fax:201-594-9440
Practice Address - Street 1:354 OLD HOOK RD
Practice Address - Street 2:SUITE G-01
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3246
Practice Address - Country:US
Practice Address - Phone:201-594-9312
Practice Address - Fax:201-594-9440
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01363900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist