Healthcare Provider Details

I. General information

NPI: 1447355151
Provider Name (Legal Business Name): ABBIE ROSENBERG RN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 WOOD ST
HOPKINTON MA
01748-1013
US

IV. Provider business mailing address

149 WOOD ST
HOPKINTON MA
01748-1013
US

V. Phone/Fax

Practice location:
  • Phone: 508-625-1660
  • Fax: 508-625-1286
Mailing address:
  • Phone: 508-625-1660
  • Fax: 508-625-1286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number173150
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: