Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD-031816-E | PA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD-031816-E | PA |
NPI | 1023038718 |
---|---|
Provider Name | Dr. Marc R. Rosen |
First Address | Philadelphia, PA 19107-4216 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 05/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001136522 | (05) | PA |
7491409 | (05) | NJ |