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General NPI Number Information
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NPI Number | 1881649416
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Entity Type | Organization
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Legal Business Name | FOX CHASE PAIN MANAGEMENT ASSOCIATES, PC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 4979 OLD STREET RD SUITE B
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City | TREVOSE
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State | PA
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Zip | 19053-6222
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Country | US
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Telephone | 267-288-5601
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Fax | 267-288-5905
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Provider Business Mailing Address
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Address Line | 4979 OLD STREET RD SUITE B
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City | TREVOSE
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State | PA
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Zip | 19053-6222
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Country | US
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Telephone | 267-288-5601
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Fax | 267-288-5905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN MARK ROSEN
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Credential | M.D.
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Telephone | 267-288-5601
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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 | MD034707E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD008053E
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License Number State | PA
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