Basic Information
Provider Information
NPI: 1760407449
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSENSON
FirstName: ROBERT
MiddleName: SIDNEY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2: BOX 1030
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2126598731
FaxNumber:  
Practice Location
Address1: 5 E 98TH ST
Address2: 3RD FLOOR
City: NEW YORK
State: NY
PostalCode: 100296501
CountryCode: US
TelephoneNumber: 2124271540
FaxNumber: 2124107196
Other Information
ProviderEnumerationDate: 07/13/2006
LastUpdateDate: 05/17/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301087688MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X036073033ILN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000X4301087688MIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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