Provider Demographics
NPI:1063760155
Name:ROSENBERG, JILL PARISER (AUD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:PARISER
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CONCORD AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4049
Mailing Address - Country:US
Mailing Address - Phone:617-484-8700
Mailing Address - Fax:
Practice Address - Street 1:90 CONCORD AVE STE 4
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4049
Practice Address - Country:US
Practice Address - Phone:617-484-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA987231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist