Provider Demographics
NPI:1124867098
Name:NURSEPRACTITIONERCO
Entity type:Organization
Organization Name:NURSEPRACTITIONERCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:347-528-2025
Mailing Address - Street 1:21 BACK DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3020
Mailing Address - Country:US
Mailing Address - Phone:347-528-2025
Mailing Address - Fax:
Practice Address - Street 1:21 BACK DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3020
Practice Address - Country:US
Practice Address - Phone:347-528-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty