1689686560 NPI number — KAREN ROSENFELD LCSW

Table of content: KAREN ROSENFELD LCSW (NPI 1689686560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689686560 NPI number — KAREN ROSENFELD LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENFELD
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1689686560
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 SCOLES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07012-1125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-777-7638
Provider Business Mailing Address Fax Number:
973-777-9311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34-00 LINWOOD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIR LAWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07410-4012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-794-1771
Provider Business Practice Location Address Fax Number:
201-256-4113
Provider Enumeration Date:
08/12/2006

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: 1041C0700X , with the licence number:  44SC05079000 , 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: 0021784 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 293356 000 . This is a "MAGELLAN ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 270264 . This is a "MHN ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7345076 . This is a "GHI ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7465388 . This is a "AETNA ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P-2457102 . This is a "OXFORD ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1135847 . This is a "MULTI PLAN ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 437366 . This is a "VALUE OPTION ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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