Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1982065033 |
---|---|
Provider Name | Itamar Rosenbaum |
First Address | Brooklyn, NY 11204-1425 |
Second Address | Brooklyn, NY 11204-3058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2016 |
Last Update Date | 17/03/2016 |