Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD041883L | PA |
NPI | 1013966514 |
---|---|
Provider Name | Dr. Scott Ira Rosen |
First Address | Easton, PA 18042 |
Second Address | Easton, PA 18042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 28/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40437 | (02) | PA |