Healthcare Provider Details

I. General information

NPI: 1346264934
Provider Name (Legal Business Name): ROSE M ST. FLEUR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4267
  • Fax: 732-776-2344
Mailing address:
  • Phone: 732-776-4267
  • Fax: 732-776-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08295500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: