Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | PS000258L | PA |
NPI | 1710184536 |
---|---|
Provider Name | Mr. Terry Martin Rosenfeld |
First Address | Yardley, PA 19067-5430 |
Second Address | Yardley, PA 19067-5512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 08/07/2007 |