MEDICARE: KYLE ROSENBERG PTA

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	225200000X	Physical Therapy Assistant	40QB00417900	NJ

General Provider Information

NPI Number	:	1669330254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE ROSENBERG PTA

Provider Business Mailing Address
First Line	:	95 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6092
Country	:	US
Telephone Number	:	973-435-0066
Fax Number	:	973-771-5531

Provider Business Practice Location Address
First Line	:	95 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6092
Country	:	US
Telephone Number	:	973-435-0066
Fax Number	:	973-771-5531

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ KYLE ROSENBERG PTA” Practice Location

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