Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 195091 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 195091 | NY |
NPI | 1659459006 |
---|---|
Provider Name | Dr. Michael George Rosenberg |
First Address | Bronx, NY 10463-1625 |
Second Address | Bronx, NY 10461-1138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01890431 | (05) | NY |