MEDICARE: DR. HERMAN ROSEN 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	207RN0300X	Nephrology Physician	085198	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	:	1518976687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERMAN ROSEN M.D.

Provider Business Mailing Address
First Line	:	1100 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1202
Country	:	US
Telephone Number	:	212-369-6228
Fax Number	:	212-410-0591

Provider Business Practice Location Address
First Line	:	1100 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1202
Country	:	US
Telephone Number	:	212-369-6228
Fax Number	:	212-410-0591

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

Provider Enumeration Date	:	08/06/2006
Last Update Date	:	09/24/2019

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Directions to “ DR. HERMAN ROSEN M.D.” Practice Location

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