Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 302292 | NY |
N | 207U00000X | Nuclear Medicine Specialist | A96556 | CA |
NPI | 1750331468 |
---|---|
Provider Name | Ron Rosen |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I08076 | (02) |