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General NPI Number Information
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NPI Number | 1255301297
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Entity Type | Individual
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Provider Name | EDWARD ROSENBAUM PHD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8302 YORK RD STE 2
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City | ELKINS PARK
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State | PA
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Zip | 19027
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Country | US
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Telephone | 215-572-6292
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Fax | 215-572-6292
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Provider Business Mailing Address
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Address Line | PO BOX 3188
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City | MAPLE GLEN
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State | PA
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Zip | 19002-8188
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS001409L
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License Number State | PA
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