Provider Demographics
NPI:1194761254
Name:ROSENGARTEN, ROBERT (MS CCC AUDIOLOGY)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ROSENGARTEN
Suffix:
Gender:M
Credentials:MS CCC AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 JAMES ST
Mailing Address - Street 2:SUITE 301 ENT @ ALLERGY ASSOCIATES
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3902
Mailing Address - Country:US
Mailing Address - Phone:732-549-3934
Mailing Address - Fax:
Practice Address - Street 1:98 JAMES ST
Practice Address - Street 2:SUITE 301 ENT @ ALLERGY ASSOCIATES
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-549-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYA00197231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7129904Medicaid
NJ075363DP9Medicare PIN