Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 049416 | NY |
Y | 1223P0221X | Pediatric Dentist | 22DI02129800 | NJ |
N | 1223P0221X | Pediatric Dentist | 22DI02129801 | NJ |
NPI | 1003960774 |
---|---|
Provider Name | Dr. Kimberly Anne Rosenfeld |
First Address | West Orange, NJ 07405 |
Second Address | West Orange, NJ 07405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |