=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568594067
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LILIA ROSENSTEIN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2481 CEDARWOOD RD ATTN NPI
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-449-5070
-----------------------------------------------------
Fax | 440-720-0702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2481 CEDARWOOD RD ATTN NPI
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-449-5070
-----------------------------------------------------
Fax | 440-720-0702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 35-04-7153-R
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------