Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35SI00218100 | NJ |
Y | 103T00000X | Psychologist | 35SI00218100 | NJ |
N | 102L00000X | Psychologist | 868 | HI |
N | 103T00000X | Psychologist | 868 | HI |
NPI | 1013110543 |
---|---|
Provider Name | Dr. Robert Joel Rosenbaum |
First Address | Princeton, NJ 08540 |
Second Address | Princeton, NJ 08540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 08/07/2007 |