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General NPI Number Information
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NPI Number | 1669935748
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Entity Type | Individual
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Provider Name | ROCHELLE MICHAELA FRUMKIN DMD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2019
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 301 MADISON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3266
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Country | US
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Telephone | 732-363-0177
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 S PARK AVE
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-2954
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02767000
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License Number State | NJ
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