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NPI Code Detail

MEDICARE: GERARD ROSENBERG LAC

MEDICARE: GERARD ROSENBERG LAC
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
1101YM0800XMental Health Counselor37AC0072300NJ

General Provider Information

NPI Number : 1659064764
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARD ROSENBERG LAC
Provider Business Mailing Address
First Line : 1076-1078 RT. 47 SOUTH
Second Line :
City : RIO GRANDE
State : NJ
Zip : 08242-1608
Country : US
Telephone Number : 609-741-6363
Fax Number :
Provider Business Practice Location Address
First Line : 1076-1078 RT. 47 SOUTH
Second Line :
City : RIO GRANDE
State : NJ
Zip : 08242-1608
Country : US
Telephone Number : 609-741-6363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2023
Last Update Date : 06/02/2023

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Directions to “ GERARD ROSENBERG LAC” Practice Location

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