Individual provider Active NPI

Elisheva C Rosen, RD

  • Registered Dietitian
  • Lakewood, NJ
National Provider Identifier
1780336040
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86114938 Issued in NJ
Practice address
5 Merlot CT
Lakewood, NJ 08701-4668
Phone
(732) 581-3211
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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 86114938 NJ Primary

Addresses

Primary practice location

5 Merlot CT
Lakewood, NJ 08701-4668

Mailing address

5 Merlot CT
Lakewood, NJ 08701-4668
Phone (732) 581-3211

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86114938NJMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1780336040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MERLOT CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014668",
            "telephone_number": "732-581-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MERLOT CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014668",
            "telephone_number": "732-581-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ELISHEVA",
        "middle_name": "C",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86114938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.