Healthcare Provider Details

I. General information

NPI: 1528577251
Provider Name (Legal Business Name): SARAH ROSENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N. MAIN ST.
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

250 E. 73RD ST. APT 6D
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-9300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF421312-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: