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General NPI Number Information
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NPI Number | 1265715833
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Entity Type | Individual
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Provider Name | MICHAEL ROSENFARB RPH
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Gender | Male
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 5305 INDIAN RIVER RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-5320
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Country | US
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Telephone | 757-467-0953
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Fax |
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Provider Business Mailing Address
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Address Line | 600 ROSAER CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-2429
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Country | US
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Telephone | 757-420-0577
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202006484
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License Number State | VA
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