Healthcare Provider Details

I. General information

NPI: 1144986696
Provider Name (Legal Business Name): SHAINA ROSENWASSER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 ROUTE 59
MONSEY NY
10952-3739
US

IV. Provider business mailing address

77 ROUTE 59
MONSEY NY
10952-3739
US

V. Phone/Fax

Practice location:
  • Phone: 845-356-2273
  • Fax:
Mailing address:
  • Phone: 845-356-2273
  • Fax: 845-579-7021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF348655-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF421616-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: