JACQUELINE ROSENBAUM (NPI# 1710496757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710496757 |
| Entity Type | Individual |
| Full Name | JACQUELINE ROSENBAUM |
| Credential | PA |
| Practice Address |
123 Everett Rd Albany NY 12205-1407 |
| Practice Telephone | 5187012000 |
| Practice Fax Number | 5187012139 |
| Mailing Telephone | 5187012000 |
| Mailing Fax Number | 5187012139 |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2020-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
021349 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730478595 | Jacqueline H Rosenbaum | Social Worker | 1329 Beach Channel Dr, Far Rockaway, NY 11691-3211 | 2011-04-01 |
| Street Address |
123 EVERETT RD |
| City | ALBANY |
| State | NY |
| Zip Code | 12205-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419232 | Gavin Setzen | Otolaryngology | 123 Everett Rd, Albany, NY 12205-1407 | 2005-07-03 |
| 1649881061 | Maria Pina Ragonese | Audiologist | 123 Everett Rd, Albany, NY 12205-1407 | 2020-08-10 |
| 1629619846 | Daniel A Horton | Physician Assistant | 123 Everett Rd, Albany, NY 12205-1407 | 2019-09-30 |
| 1912553017 | Courtney Leadbeater | Audiologist | 123 Everett Rd, Albany, NY 12205-1407 | 2019-08-14 |
| 1164083911 | Everett Road Asc, LLC | Clinic/Center | 123 Everett Rd, Albany, NY 12205-1407 | 2019-06-24 |
| 1669841920 | Andrew Larsen | Physician Assistant | 123 Everett Rd, Albany, NY 12205 | 2015-09-16 |
| 1255772232 | Michael J Rizzuto | Physician Assistant | 123 Everett Rd, Albany, NY 12205-1407 | 2013-07-08 |
| 1750649760 | Jessica Lynn Riccio | Otolaryngology | 123 Everett Rd, Albany, NY 12205-1407 | 2012-04-26 |
| 1730461914 | Dana A Wilhite | Audiologist | 123 Everett Rd, Albany, NY 12205-1407 | 2011-09-14 |
| 1760641096 | Nora Whitbeck Perkins | Otolaryngology | 123 Everett Rd, Albany, NY 12205-1407 | 2008-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564053 | Capital Regional Rx LLC | Pharmacy | 431 New Karner Road Bldg#4 Suite 180, Albany, NY 12205 | 2020-10-07 |
| 1548722549 | The Alternative Living Group, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 New Karner Road, Suite 3, Albany, NY 12205 | 2019-04-01 |
| 1003398439 | Sarah Itwaru | Social Worker | 401 New Karner Road, Albany, NY 12205 | 2018-09-01 |
| 1740708106 | Kenneth Cook | Physician Assistant | 121everett Rd, Albany, NY 12205 | 2017-09-06 |
| 1437691839 | Sarah Avery | Physical Therapist | 5 S Family Dr, Colonie, NY 12205 | 2016-11-16 |
| 1063892776 | Olsen Medical Sales, LLC | Durable Medical Equipment & Medical Supplies | 98 Everett Rd, Albany, NY 12205 | 2015-06-08 |
| 1972921484 | Alixandra Joy Foisy | Social Worker | 42 Oakwood Dr, Albany, NY 12205 | 2014-04-01 |
| 1780015206 | The Promptcare Companies | Durable Medical Equipment & Medical Supplies | 1015c Central Avenue, Albany, NY 12205 | 2013-12-09 |
| 1396088332 | Early Childhood Education Center | Day Training, Developmentally Disabled Services | 251 Washington Ave Extension, Albany, NY 12205 | 2013-03-28 |
| 1487906707 | Centerfordisabiltyservices | Preferred Provider Organization | 5 Keller Street, Albany, NY 12205 | 2012-10-10 |
| Find all providers in zip 12205 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912486747 | Karen Duane | Physician Assistant | 48 New Scotland Ave, Albany, NY 12208 | 2018-08-13 |
| 1740708106 | Kenneth Cook | Physician Assistant | 121everett Rd, Albany, NY 12205 | 2017-09-06 |
| 1356722714 | Megan Weitzel | Physician Assistant | 50 New Scotland Ave # Mc-190, Albany, NY 12208-3403 | 2015-06-11 |
| 1063899847 | Philip Rabadi | Physician Assistant | 27 Westlyn Ct, Albany, NY 12203-3463 | 2015-04-30 |
| 1467885459 | Heather Freeman | Physician Assistant | 1980 Western Ave, Apt 731, Albany, NY 12203-5051 | 2013-08-14 |
| 1861509531 | Tracy Dee Amsden | Physician Assistant | 1365 Washington Ave Ste 300, Albany, NY 12206-1098 | 2006-08-25 |
| 1124015748 | Dan C West | Physician Assistant | 605 N Westover Blvd, Albany, GA 31707-2188 | 2005-09-29 |
| 1750378329 | Sheri B Smith | Physician Assistant | 2311 Lake Park Drive, Albany, GA 31707 | 2005-09-29 |
| 1942816368 | Brian D Klassner | Physician Assistant | 121 Everett Rd Ste 100, Albany, NY 12205-1447 | 2020-09-21 |
| 1114535077 | Jonathan Stephens | Physician Assistant | 121 Everett Rd Ste 100, Albany, NY 12205-1447 | 2020-07-16 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.