Basic Information
Provider Information
NPI: 1386789717
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSINSKI
FirstName: AMY
MiddleName: BETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 E MEDICAL CENTER DR
Address2: 9TH FLOOR UNIVERSITY HOSPITAL RECP D
City: ANN ARBOR
State: MI
PostalCode: 481095118
CountryCode: US
TelephoneNumber: 7347645348
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/21/2007
LastUpdateDate: 07/22/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0015X4301081867MIN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
2084P0800X4301081687MIY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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