Healthcare Provider Details

I. General information

NPI: 1992623920
Provider Name (Legal Business Name): TEDI ROSENSTEIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST
BOSTON MA
02111-1552
US

IV. Provider business mailing address

93 PATRICIA LN
WEYMOUTH MA
02190-1207
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-2523
  • Fax:
Mailing address:
  • Phone: 617-636-2523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2321912
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: