Healthcare Provider Details

I. General information

NPI: 1659459006
Provider Name (Legal Business Name): DR. MICHAEL GEORGE ROSENBERG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

3635 JOHNSON AVE
BRONX NY
10463-1625
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-3060
  • Fax: 718-918-4469
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number195091
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number195091
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: