Individual provider Active NPI

Laura Karen Rosenberg, R.D.

  • Registered Dietitian
  • Glen Cove, NY
National Provider Identifier
1083917454
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000710 Issued in NY
Practice address
70 Glen St Ste 101
Glen Cove, NY 11542-2853
Phone
(631) 320-8833
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000710 NY Primary

Addresses

Primary practice location

70 Glen St Ste 101
Glen Cove, NY 11542-2853

Mailing address

17 Southland Dr
Glen Cove, NY 11542-1026
Phone (631) 235-9881

Other practice location 1

112 Cliff Rd
Port Jefferson, NY 11777
Phone (631) 235-9881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000710NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Medicine Associates, P.C. CurrentSince Jul 27, 2020 Accepting new patients

Locations

70 Glen St
Ste 101
Glen Cove, NY 11542
Phone (516) 630-3525

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1083917454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SOUTHLAND DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421026",
            "telephone_number": "631-235-9881",
            "fax_number": "888-279-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 101",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422853",
            "telephone_number": "631-320-8833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Cliff Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "11777",
            "country_code": "US",
            "telephone_number": "631-235-9881",
            "fax_number": "631-474-1909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "LAURA",
        "middle_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.