Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 25MA02192900 | NJ |
NPI | 1013181338 |
---|---|
Provider Name | Robert Alan Rosenfeld |
First Address | Oakhurst, NJ 07755-0400 |
Second Address | Ocean, NJ 07712-3344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2008 |
Last Update Date | 17/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C90390 | (02) |