Healthcare Provider Details

I. General information

NPI: 1710157789
Provider Name (Legal Business Name): GERALD M ROSMARIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 WHITE PLAINS RD SUITE 500
TARRYTOWN NY
10591-5113
US

IV. Provider business mailing address

358 N BROADWAY SUITE203
SLEEPY HOLLOW NY
10591-2322
US

V. Phone/Fax

Practice location:
  • Phone: 914-333-5877
  • Fax:
Mailing address:
  • Phone: 914-631-3053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number082675
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: