Healthcare Provider Details

I. General information

NPI: 1699764498
Provider Name (Legal Business Name): MICHAEL J ROZENGARTEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 PHEASANT RUN STE 128
NEWTOWN PA
18940-3428
US

IV. Provider business mailing address

104 PHEASANT RUN SUITE 128
NEWTOWN PA
18940-3439
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-3344
  • Fax: 215-860-3348
Mailing address:
  • Phone: 215-860-3344
  • Fax: 215-860-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number25MA07995700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD427309
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: