Healthcare Provider Details

I. General information

NPI: 1467485268
Provider Name (Legal Business Name): ERIC J ROSENBAUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIC JOHN ROSENBAUM M.D.

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MOUNT KEMBLE AVE STE 350
MORRISTOWN NJ
07960-8008
US

IV. Provider business mailing address

1200 MOUNT KEMBLE AVE STE 350
MORRISTOWN NJ
07960-8008
US

V. Phone/Fax

Practice location:
  • Phone: 973-993-4445
  • Fax: 973-993-4942
Mailing address:
  • Phone: 973-993-4445
  • Fax: 973-993-4942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number221883
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberMD-23386-0
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number25MA07439100
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberC185346
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: