Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 217497-1 | NY |
NPI | 1275534687 |
---|---|
Provider Name | Barak Meir Rosenn |
First Address | Philadelphia, PA 19195-4930 |
Second Address | New York, NY 10019-1147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 07/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02103015 | (05) | NY |
10489364 | CAQH ID (01) | |
217497-1 | NYS LICENSE (01) | NY |
BR2913843 | DEA (01) | |
F06360 | (02) | NY |