Healthcare Provider Details

I. General information

NPI: 1417054396
Provider Name (Legal Business Name): ROCHELLE GREENFIELD MA, RN, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 CLARKEN DR
WEST ORANGE NJ
07052-3434
US

IV. Provider business mailing address

229 CLARKEN DR
WEST ORANGE NJ
07052-3434
US

V. Phone/Fax

Practice location:
  • Phone: 973-731-7318
  • Fax:
Mailing address:
  • Phone: 973-731-7318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNC48514
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: