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General NPI Number Information
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NPI Number | 1437153897
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Entity Type | Individual
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Provider Name | ROSARIO P FERNANDO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 300 CENTRAL AVE
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City | EAST ORANGE
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State | NJ
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Zip | 07018-2819
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Country | US
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Telephone | 973-672-8400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 827944
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City | PHILADELPHIA
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State | PA
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Zip | 19182-7944
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Country | US
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Telephone | 201-804-2800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA03451200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA03451200
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License Number State | NJ
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