Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 028904 | CT |
N | 207RH0000X | Hematologist | 55862 | MA |
N | 207RH0003X | Hematology & Oncology | 028904 | CT |
Y | 207RH0003X | Hematology & Oncology | 55862 | MA |
N | 207RX0202X | Medical Oncology | 028904 | CT |
N | 207RX0202X | Medical Oncology | 55862 | MA |
NPI | 1407884182 |
---|---|
Provider Name | Michael Henry Rosen |
First Address | Springfield, MA 01104 |
Second Address | Springfield, MA 01104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 10/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010028940CT01 | BLUE CROSS BLUE SHIELD (01) | CT |
010055862MA01 | BLUE CROSS BLUE SHIELD (01) | CT |
055862 | TUFTS HEALTH PLAN (01) | MA |
18363 | HEALTH NEW ENGLAND (01) | MA |
3007928 | (05) | MA |
A64365 | (02) | |
J05432 | BLUE CROSS BLUE SHIELD (01) | MA |