1669523783 NPI number — DR. ALAN J ROSEN D.P.M.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669523783 NPI number — DR. ALAN J ROSEN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSEN
Provider First Name:
ALAN
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

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:
1669523783
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
177 E 87TH ST
Provider Second Line Business Mailing Address:
SUITE407
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10128-2226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-861-2997
Provider Business Mailing Address Fax Number:
212-861-3749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
177 E 87TH ST
Provider Second Line Business Practice Location Address:
SUITE407
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10128-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-861-2997
Provider Business Practice Location Address Fax Number:
212-861-3749
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  N004590 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213EP1101X , with the licence number: N004590 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0000X , with the licence number: N004590 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0131X , with the licence number: N004590 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: P50842 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480029371 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P50841 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01179506 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: KS4442997 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com