| Rosefortmd Llc | |
|
240 Williamson St Ste 205 Elizabeth NJ 07202-3672 | |
| (908) 289-8340 | |
| (908) 576-3456 |
| Full Name | Rosefortmd Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 240 Williamson St Ste 205, Elizabeth, New Jersey |
| Authorized Official Name and Position | Doreen Colorio (BILLING MANAGER) |
| Authorized Official Contact | 7326733057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosefortmd Llc 31 Osborne St Bloomfield NJ 07003-2714 Ph: () - | Rosefortmd Llc 240 Williamson St Ste 205 Elizabeth NJ 07202-3672 Ph: (908) 289-8340 |
| NPI Number | 1154014371 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 06/01/2023 |
| Medicare PECOS PAC ID | 4880048230 |
|---|---|
| Medicare Enrollment ID | O20231004000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154014371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Laury Rosefort |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942575253 PECOS PAC ID: 1052606746 Enrollment ID: I20160819000461 |
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