Healthcare Provider Details

I. General information

NPI: 1770406142
Provider Name (Legal Business Name): ANYA ROSSINSKAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOUNT PLEASANT AVE STE E
DOVER NJ
07801-1630
US

IV. Provider business mailing address

2467 NJ-10 22-5A
MORRIS PLAINS NJ
07950
US

V. Phone/Fax

Practice location:
  • Phone: 973-361-6200
  • Fax:
Mailing address:
  • Phone: 929-497-3830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03162400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: