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NPI Code Detail

MEDICARE: STEFANIE M. ROSENBERG P.A.

MEDICARE: STEFANIE M. ROSENBERG P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant63921CA
2363AM0700XMedical Physician Assistant2521-023WI

General Provider Information

NPI Number : 1366435083
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFANIE M. ROSENBERG P.A.
Provider Business Mailing Address
First Line : 500 W BROWN DEER RD
Second Line :
City : BAYSIDE
State : WI
Zip : 53217-1627
Country : US
Telephone Number : 414-434-0461
Fax Number : 414-434-0467
Provider Business Practice Location Address
First Line : 500 W BROWN DEER RD
Second Line :
City : BAYSIDE
State : WI
Zip : 53217-1627
Country : US
Telephone Number : 414-434-0461
Fax Number : 414-434-0467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 09/10/2024

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Directions to “ STEFANIE M. ROSENBERG P.A.” Practice Location

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