Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD019565E | PA |
NPI | 1013062991 |
---|---|
Provider Name | Dr. Bruce J Rosen |
First Address | Rose Valley, PA 19086-6719 |
Second Address | Folsom, PA 19033-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C31936 | (02) | PA |