Individual
LISA ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6134 188TH STREET, SUITE 219, FRESH MEADOWS, NY 11365
(718) 454-3200
(718) 465-4865
Mailing address
990 STEWART AVE, SUITE 400, GARDEN CITY, NY 11530-4822
(516) 222-2022
(516) 222-8475
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
151716
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29D771LR
BCBS
—
01
—
DP350
OXFORD
—
Enumeration date
11/09/2006
Last updated
01/31/2012
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