Provider Demographics
NPI:1578364196
Name:ROTENBERG, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ROTENBERG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-9316
Mailing Address - Country:US
Mailing Address - Phone:413-770-6232
Mailing Address - Fax:
Practice Address - Street 1:1474 COUNTY RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-9316
Practice Address - Country:US
Practice Address - Phone:413-770-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula