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General NPI Number Information
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NPI Number | 1679556195
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Entity Type | Individual
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Provider Name | WAYNE LAWRENCE ROSEN DO
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 900 23RD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-2342
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Country | US
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Telephone | 202-715-5154
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Fax |
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Provider Business Mailing Address
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Address Line | 239 MAIN ST SUITE 400
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City | JOHNSTOWN
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State | PA
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Zip | 15901-1640
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Country | US
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Telephone | 814-539-5987
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Fax | 814-535-4176
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01053854A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS015365
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO210012511
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License Number State | DC
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