MEDICARE: ROSH OB-GYN ULTRASOUND OF NJ LLC

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
1	207VG0400X	Gynecology Physician

General Provider Information

NPI Number	:	1730635749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSH OB-GYN ULTRASOUND OF NJ LLC

Provider Business Mailing Address
First Line	:	PO BOX 231023
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11023-0023
Country	:	US
Telephone Number	:	718-253-8111
Fax Number	:	718-253-2333

Provider Business Practice Location Address
First Line	:	1973 SPRINGFIELD AVE
Second Line	:
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-3435
Country	:	US
Telephone Number	:	973-996-2284
Fax Number	:	212-725-3738

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	SUSAN BOUSKILA
Credential	:
Telephone Number	:	718-253-8111

Provider Enumeration Date	:	08/30/2016
Last Update Date	:	08/30/2016

Similar Medicare Providers

1972598829 — MRS. WINSOME JOAN PARCHMENT M.D.
Practice Location Address:

1973 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-313-2501
Practice Fax: 973-313-2505

1730231234 — DR. MARVEN H WALLEN M.D.
Practice Location Address:

1985 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-763-5010
Practice Fax: 973-761-6980

1053507566 — MARVEN WALLEN & S. KENNETH JACOBSON, MD PA
Practice Location Address:

1985 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-763-5010
Practice Fax: 973-761-6980

1508020157 — METROPOLITAN OB/GYN, P.A.
Practice Location Address:

1973 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-313-2501
Practice Fax: 973-313-2505

1992154678 — METROPOLITAN OBGYN
Practice Location Address:

1973 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-996-2600
Practice Fax: 973-996-2601

1154771400 — LYNN GRAFFEO FNP
Practice Location Address:

1973 SPRINGFIELD AVE
MAPLEWOOD, NJ
07040-3435

Practice Phone: 973-313-2501
Practice Fax: 973-313-2505

Directions to “ROSH OB-GYN ULTRASOUND OF NJ LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.