Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD428699 | PA |
NPI | 1053380105 |
---|---|
Provider Name | Andrew B Rosenzweig |
First Address | Philadelphia, PA 19178-8735 |
Second Address | Philadelphia, PA 19141-3018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 21/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101854272 | (05) | PA |