MEDICARE: DR. ALAN S ROSENBERG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	090590	NY

General Provider Information

NPI Number	:	1013910165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN S ROSENBERG M.D.

Provider Business Mailing Address
First Line	:	1010 NORTHERN BLVD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5306
Country	:	US
Telephone Number	:	516-390-2410
Fax Number	:	516-482-7955

Provider Business Practice Location Address
First Line	:	1010 NORTHERN BLVD
Second Line	:	STE 110
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5306
Country	:	US
Telephone Number	:	516-390-2410
Fax Number	:	516-482-7955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/04/2011

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