Organization
JERRY H ROSENBERG MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONELLE W COUCH (BUSINESS OFFICE MANAGER)
55048875555
Entity
Organization
Contact information
Practice address
67250 INDUSTRY LN, SUITE B, COVINGTON, LA 70433-8716
(985) 892-3456
(985) 892-3499
Mailing address
4224 HOUMA BLVD, 260, METAIRIE, LA 70006-2933
(504) 887-5555
(504) 888-5031
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
010614
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1365939
—
LA
Enumeration date
03/23/2007
Last updated
08/22/2020
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