MEDICARE: CHAYA ROSENBERG RD, RN, CNL

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	133V00000X	Registered Dietitian	821980	NY
2	163WN0002X	Neonatal Intensive Care Registered Nurse	0026NR14644800	NJ
3	163WA2000X	Administrator Registered Nurse	0026NR14644800	NJ

General Provider Information

NPI Number	:	1669538351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAYA ROSENBERG RD, RN, CNL

Provider Business Mailing Address
First Line	:	293 LUPINE WAY
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078
Country	:	US
Telephone Number	:	347-612-9105
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 MOUNTAIN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2515
Country	:	US
Telephone Number	:	973-912-9817
Fax Number	:

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/21/2022

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