Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA06263000 | NJ |
N | 207YS0123X | Facial Plastic Surgeon | 25MA06263000 | NJ |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 25MA06263000 | NJ |
NPI | 1407823404 |
---|---|
Provider Name | Arie Rosen |
First Address | Hackensack, NJ 07601-1117 |
Second Address | Hackensack, NJ 07601-1117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 11/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G19667 | (02) |