Provider Demographics
NPI:1962745711
Name:EBERT, ROSEANNE (CD(DONA) LCCE)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:
Last Name:EBERT
Suffix:
Gender:F
Credentials:CD(DONA) LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 EASTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2113
Mailing Address - Country:US
Mailing Address - Phone:201-857-2061
Mailing Address - Fax:
Practice Address - Street 1:572 EASTBROOK RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2113
Practice Address - Country:US
Practice Address - Phone:201-857-2061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-30
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula