Healthcare Provider Details

I. General information

NPI: 1699919134
Provider Name (Legal Business Name): HAROLD A. ROSENE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. HAROLD A. ROSENE JR.

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 HARRINGTON RD.
PEMAQUID ME
04558
US

IV. Provider business mailing address

PO BOX 499
NEW HARBOR ME
04554-0499
US

V. Phone/Fax

Practice location:
  • Phone: 207-677-3138
  • Fax:
Mailing address:
  • Phone: 207-677-3138
  • Fax: 207-677-6484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number005290
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: