Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 72861 | MA |
NPI | 1033200944 |
---|---|
Provider Name | Beth A. Rosen |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 26/01/2018 |