1851431936 NPI number — BENJAMIN I ROSIN, MD PC

Table of content: (NPI 1851431936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851431936 NPI number — BENJAMIN I ROSIN, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BENJAMIN I ROSIN, MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851431936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6501 E GREENWAY PKWY
Provider Second Line Business Mailing Address:
SUITE 103-611
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85254-2065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-765-4499
Provider Business Mailing Address Fax Number:
602-765-0405

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4921 E BELL RD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85254-6002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-765-4499
Provider Business Practice Location Address Fax Number:
602-765-0405
Provider Enumeration Date:
02/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROSIN
Authorized Official First Name:
BENJAMIN
Authorized Official Middle Name:
IVAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
602-765-4499

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  26039 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)