Healthcare Provider Details

I. General information

NPI: 1124400346
Provider Name (Legal Business Name): RACHEL ROSEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 BARNES AVE
WESTMINSTER MD
21157-5954
US

IV. Provider business mailing address

7848 OLD YORK RD SUITE 200
ELKINS PARK PA
19027-2541
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-5625
  • Fax:
Mailing address:
  • Phone: 267-287-8892
  • Fax: 267-287-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD072626L
License Number StatePA

VIII. Authorized Official

Name: DR. RACHEL ROSEN
Title or Position: OWNER
Credential: M.D.
Phone: 267-287-8892