Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 81796 | MA |
NPI | 1144208695 |
---|---|
Provider Name | Jay E Rosenfeld |
First Address | Duxbury, MA 02331-2540 |
Second Address | East Sandwich, MA 02563-1370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 31/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G06318 | (02) | MA |