Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 195601-1 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA06952800 | NJ |
NPI | 1245262880 |
---|---|
Provider Name | Todd J Rosen |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-1962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01693723 | (05) | NY |
8250006 | (05) | NJ |
G36708 | (02) | NY |