Basic Information
| Provider Information | |||||||||
| NPI: | 1558455055 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENBERGER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2543 APPLE ST | ||||||||
| Address2: | |||||||||
| City: | HELLERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180553209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108387096 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3445 HIGH POINT BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108665555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 05/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP00059700 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | MA003152L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.