N J Dermatopathology

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

25MA03949600. Issued in NJ

Legal business name

N J DERMATOPATHOLOGY

Practice address

769 Northfield Ave Ste LL30
West Orange, NJ 07052

Phone

(973) 669-0141

Fax

(973) 669-8220

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Jerry Rothenberg, MDNPI 1942481551

Title

Medical Director

Phone

(973) 669-0141

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Rothenberg, MD

  • Dermatopathology Physician
  • West Orange, NJ
  • NPI 1942481551
  NPD (past) Authorized official

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1275606998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE STE LL30",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-669-0141",
            "fax_number": "973-669-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE STE LL30",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-669-0141",
            "fax_number": "973-669-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N J DERMATOPATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "ROTHENBERG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-669-0141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": "25MA03949600.",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300609",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "1220021085",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Muller, PT, DPT
• Annie M Mulvaney, PHYSICIAN ASSISTANT
• Kristen Murphy
• Kabulo Blanche Mwilambwe
• James Myers, ATC
• Diane Sue Naar, MSW LSW
• Elina Nachevnik, M.D.
• Katherine Nadelberg
• William Benjamin Nadelberg, D.C.
• Joshua Naiman

• Dermatopathology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Dermatopathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.