Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 0101042415 | VA |
NPI | 1306836820 |
---|---|
Provider Name | Faye Rosenbaum |
First Address | Arlington, VA 22205-3601 |
Second Address | Arlington, VA 22205-3601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 30/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6100317 | (05) | VA |
C62089 | (02) |