Healthcare Provider Details

I. General information

NPI: 1346332368
Provider Name (Legal Business Name): OTOLARYNGOLOGY ASSOCIATES OF CENTRAL NEW JERSEY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B3 CORNWALL CT
EAST BRUNSWICK NJ
08816-3352
US

IV. Provider business mailing address

B3 CORNWALL DR
EAST BRUNSWICK NJ
08816-3352
US

V. Phone/Fax

Practice location:
  • Phone: 732-238-0300
  • Fax: 732-238-4066
Mailing address:
  • Phone: 732-238-0300
  • Fax: 732-238-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. JEFFREY MARK ROSENBAUM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-238-0300