=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720146624
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA B ROSENBAUM MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2006
-----------------------------------------------------
Last Update Date | 12/23/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10500 SUMMIT AVENUE
-----------------------------------------------------
City | KANSINGTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20895-2138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-897-2325
-----------------------------------------------------
Fax | 301-897-2333
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10500 SUMMIT AVENUE
-----------------------------------------------------
City | KENSINGTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20895-2422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-897-2325
-----------------------------------------------------
Fax | 310-897-2333
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | D59725
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD33138
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------