Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS020618L | PA |
NPI | 1134344674 |
---|---|
Provider Name | Dr. Sol Rosenberg |
First Address | Narberth, PA 19072-2031 |
Second Address | Narberth, PA 19072-2031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 31/01/2008 |