Healthcare Provider Details

I. General information

NPI: 1679655419
Provider Name (Legal Business Name): ROSITTA MICHAEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR FL 4 (PEDIATRIC HOSPITALIST)
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

2100 WESCOTT DR FL 4 (PEDIATRIC HOSPITALIST)
FLEMINGTON NJ
08822-4603
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6100
  • Fax:
Mailing address:
  • Phone: 908-788-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMAO7770500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: