MEDICARE: DR. CAROL ROSENBAUM MD

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	174400000X	Specialist	178996	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225051923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL ROSENBAUM MD

Provider Business Mailing Address
First Line	:	175 W 93RD ST
Second Line	:	APT. 16A
City	:	NEW YORK
State	:	NY
Zip	:	10025-9313
Country	:	US
Telephone Number	:	212-410-4848
Fax Number	:	212-996-0779

Provider Business Practice Location Address
First Line	:	1185 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1308
Country	:	US
Telephone Number	:	212-410-4848
Fax Number	:	212-996-0779

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	03/04/2008

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