Healthcare Provider Details

I. General information

NPI: 1932418126
Provider Name (Legal Business Name): AVISHAI ROSENSTEIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 OLD HOOK RD SUITE G-01
WESTWOOD NJ
07675-3246
US

IV. Provider business mailing address

354 OLD HOOK RD SUITE G-01
WESTWOOD NJ
07675-3246
US

V. Phone/Fax

Practice location:
  • Phone: 201-594-9312
  • Fax: 201-594-9440
Mailing address:
  • Phone: 201-594-9312
  • Fax: 201-594-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01363900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: