MEDICARE: BRENT ROSEN, D.O., LLC

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	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1801126370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRENT ROSEN, D.O., LLC

Provider Business Mailing Address
First Line	:	401 HYDE PARK
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18902-6619
Country	:	US
Telephone Number	:	267-247-5345
Fax Number	:	267-247-5375

Provider Business Practice Location Address
First Line	:	401 HYDE PARK
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18902-6619
Country	:	US
Telephone Number	:	267-247-5345
Fax Number	:	267-247-5375

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRENT ROSEN
Credential	:	D.O,
Telephone Number	:	610-930-9900

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	06/03/2010

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