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NPI Code Detail

MEDICARE: ROSETTA GENOMICS, INC.

MEDICARE: ROSETTA GENOMICS, INC.
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
1291U00000XClinical Medical Laboratory030877PA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1210242OTHERPAHIGHMARK MEDICARE

General Provider Information

NPI Number : 1962641563
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSETTA GENOMICS, INC.
Provider Business Mailing Address
First Line : PO BOX 11979
Second Line :
City : NEWARK
State : NJ
Zip : 07101-4979
Country : US
Telephone Number : 888-522-7971
Fax Number : 215-382-0815
Provider Business Practice Location Address
First Line : 3711 MARKET ST
Second Line : SUITE 740
City : PHILADELPHIA
State : PA
Zip : 19104-5504
Country : US
Telephone Number : 215-382-9000
Fax Number : 215-382-0815
Authorized Official
Title or Position : CEO
Name : MR. KEN BERLIN
Credential :
Telephone Number : 888-522-7971
Provider Enumeration Date : 02/05/2009
Last Update Date : 10/10/2011

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