MEDICARE: NANCY A ROTHENBERG DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MB05630800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	13347	OTHER	USHC
2	BP197	OTHER	OXFORD
3	221941517009	OTHER	PRUDENTIAL
4	8849471008	OTHER	CIGNA
5	23785	OTHER	MASTERCARE
6	040056308NJ01	OTHER	ANTHEM HEALTH
7	80672	OTHER	AMERIGROUP
8	1979064	OTHER	UNITED HLTHCR
9	998604	OTHER	HEALTHNET REFERRAL
10	4233290	OTHER	AETNA
11	58H201	OTHER	EMPIRE HLTHCR
12	F01397	OTHER	HEALTHNET
13	4241232	OTHER	AETNA
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326056227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY A ROTHENBERG DO

Provider Business Mailing Address
First Line	:	215 OLD TAPPAN RD
Second Line	:	OLD TAPPAN PEDIATRICS
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675
Country	:	US
Telephone Number	:	201-666-1000
Fax Number	:	201-666-7610

Provider Business Practice Location Address
First Line	:	215 OLD TAPPAN RD
Second Line	:
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675
Country	:	US
Telephone Number	:	201-666-1000
Fax Number	:	201-666-7610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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Directions to “ NANCY A ROTHENBERG DO” Practice Location

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