1245232677 NPI number — JANE ROSENFELD

Table of content: JANE ROSENFELD (NPI 1245232677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245232677 NPI number — JANE ROSENFELD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENFELD
Provider First Name:
JANE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1245232677
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2090 ROUTE 27
Provider Second Line Business Mailing Address:
PINES PLAZA
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08817-3372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-287-6663
Provider Business Mailing Address Fax Number:
732-287-6664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2090 ROUTE 27
Provider Second Line Business Practice Location Address:
PINES PLAZA
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08817-3372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-287-6663
Provider Business Practice Location Address Fax Number:
732-287-6664
Provider Enumeration Date:
08/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA04817100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0527315000 . This is a "AMERIHEALTH #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5614705 . This is a "AETNA PPO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00976719 . This is a "RR MCR" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P735790 . This is a "OXFORD #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 110230392 . This is a "RR MDCR #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0K3398 . This is a "HEALTHNET #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 917371 . This is a "EMPIRE BC/BS #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2056402 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2069917 . This is a "AETNA HMO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 210749 . This is a "UNIFORMED SERVICES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223586872 . This is a "TAX IDENTIFICATION #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 18083 . This is a "UNIVERSITY HEALTH PLANS #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2900493 . This is a "GHI PPO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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