1174507719 NPI number — ROBERT J ROSENBAUM EDD PA

Table of content: MRS. JANEL P SAUNDERS NP (NPI 1316940448)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174507719 NPI number — ROBERT J ROSENBAUM EDD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT J ROSENBAUM EDD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BUNKER HILL CONSULTATION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174507719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 THREE ACRE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08540-8437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-874-5115
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 THREE ACRE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-8437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-874-5115
Provider Business Practice Location Address Fax Number:
908-874-7210
Provider Enumeration Date:
12/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROSENBAUM
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
JOEL
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
908-874-5115

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103T00000X , with the licence number: SI0002181 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103T00000X , with the licence number: 868 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TF0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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