Healthcare Provider Details

I. General information

NPI: 1518063627
Provider Name (Legal Business Name): TAMAR ROSNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 48TH ST
BROOKLYN NY
11219-2919
US

IV. Provider business mailing address

747 LONGACRE AVE
WOODMERE NY
11598-2338
US

V. Phone/Fax

Practice location:
  • Phone: 718-436-3705
  • Fax: 718-435-6188
Mailing address:
  • Phone: 516-295-6884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number223410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: