Provider Demographics
NPI:1538039037
Name:BROWN, ROSETTA (653-10623PH1)
Entity type:Individual
Prefix:
First Name:ROSETTA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:653-10623PH1
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Mailing Address - Street 1:100 MAPLEWOOD DR APT B
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-1970
Mailing Address - Country:US
Mailing Address - Phone:609-712-3926
Mailing Address - Fax:609-712-3926
Practice Address - Street 1:1209 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3532
Practice Address - Country:US
Practice Address - Phone:856-320-8553
Practice Address - Fax:856-320-8553
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ653-10623246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy