Healthcare Provider Details

I. General information

NPI: 1316012578
Provider Name (Legal Business Name): ELIZABETH DELROSARIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 OLD HOOK RD
WESTWOOD NJ
07675-3123
US

IV. Provider business mailing address

PO BOX 419430
BOSTON MA
02241-9430
US

V. Phone/Fax

Practice location:
  • Phone: 201-385-6161
  • Fax: 201-385-1671
Mailing address:
  • Phone: 201-666-3900
  • Fax: 201-261-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA04996100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: