Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 152490 | NY |
NPI | 1003930850 |
---|---|
Provider Name | Dr. Suzanne Rosenfeld |
First Address | Bronx, NY 10471-1237 |
Second Address | New York, NY 10024-5307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C08779 | (02) | NY |