Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA01689000 | NJ |
NPI | 1114507027 |
---|---|
Provider Name | Dr. Etana Rossman |
First Address | Paramus, NJ 07652-2204 |
Second Address | Paramus, NJ 07652-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2021 |
Last Update Date | 13/04/2021 |