Provider Demographics
NPI:1144314758
Name:ROSENBERG, AMY JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:JEAN
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:71 ORION ROAD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922
Mailing Address - Country:US
Mailing Address - Phone:908-419-5265
Mailing Address - Fax:
Practice Address - Street 1:1260 S CAMPBELL AVE
Practice Address - Street 2:BUILDING 2
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0503
Practice Address - Country:US
Practice Address - Phone:520-407-5400
Practice Address - Fax:520-407-5990
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA42919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD19772Medicare UPIN
NJ502215MHBMedicare ID - Type Unspecified