Provider Demographics
NPI:1942216064
Name:MOSER, ROSEMARIE S (PH D)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:S
Last Name:MOSER
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLDG 5
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-895-1070
Mailing Address - Fax:609-896-2030
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BLDG 5
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-895-1070
Practice Address - Fax:609-896-2030
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02148103G00000X, 103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
R31403Medicare UPIN
NJ453186DGQMedicare ID - Type Unspecified