Healthcare Provider Details

I. General information

NPI: 1578765244
Provider Name (Legal Business Name): JOSHUA SETH ROVNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 CURRY AVE STE A
ENGLEWOOD NJ
07631-1794
US

IV. Provider business mailing address

440 CURRY AVE SUITE A
ENGLEWOOD NJ
07631
US

V. Phone/Fax

Practice location:
  • Phone: 201-227-1299
  • Fax:
Mailing address:
  • Phone: 201-227-1299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number103096
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: