Healthcare Provider Details

I. General information

NPI: 1831897933
Provider Name (Legal Business Name): DR. TRACEY ROSENFELD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 N SCOTTSDALE RD STE 14
SCOTTSDALE AZ
85257-1352
US

IV. Provider business mailing address

2515 N SCOTTSDALE RD STE 14
SCOTTSDALE AZ
85257-1352
US

V. Phone/Fax

Practice location:
  • Phone: 480-656-1147
  • Fax:
Mailing address:
  • Phone: 480-656-1147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TRACEY ALAYNE RYDER
Title or Position: OWNER
Credential: DC
Phone: 480-656-1147