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General NPI Number Information
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NPI Number | 1619079290
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Entity Type | Individual
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Provider Name | BENJAMIN ROSENSTADT MD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 2566 BANKER AVE
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City | NISKAYUNA
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State | NY
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Zip | 12309-3503
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Country | US
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Telephone | 212-255-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 2566 BANKER AVE
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City | NISKAYUNA
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State | NY
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Zip | 12309-3503
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Country | US
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Telephone | 212-255-2828
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Fax | 212-265-3130
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1669911
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License Number State | NY
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