MEDICARE: DR. ROSEANNE D DOBKIN PHD

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	103T00000X	Psychologist	35SI00422000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528141231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEANNE D DOBKIN PHD

Provider Business Mailing Address
First Line	:	66 W GILBERT ST
Second Line	:	2ND FLOOR
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4947
Country	:	US
Telephone Number	:	732-212-0051
Fax Number	:	732-212-0713

Provider Business Practice Location Address
First Line	:	671 HOES LN W STE 338A
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-8021
Country	:	US
Telephone Number	:	732-235-7647
Fax Number	:	732-235-4220

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/23/2021

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