Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 164941 | NY |
NPI | 1356360267 |
---|---|
Provider Name | Richard Rosenfeld |
First Address | Brooklyn, NY 11201-5502 |
Second Address | Brooklyn, NY 11201-5502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01376856 | (05) | NY |
E90437 | (02) | NY |