Healthcare Provider Details

I. General information

NPI: 1013532431
Provider Name (Legal Business Name): DANIEL BENJAMIN ROSEN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST # 1L2
BOSTON MA
02115-6106
US

IV. Provider business mailing address

75 FRANCIS ST # 1L2
BOSTON MA
02115-6106
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-6310
  • Fax:
Mailing address:
  • Phone: 617-732-6310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number1024585
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: