Provider Demographics
NPI:1982424313
Name:ROSSITER, SABRINA A
Entity type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:A
Last Name:ROSSITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 LONG BRANCH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1153
Mailing Address - Country:US
Mailing Address - Phone:609-892-6166
Mailing Address - Fax:
Practice Address - Street 1:633 RTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8007
Practice Address - Country:US
Practice Address - Phone:732-240-4787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15188500363LF0000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty