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General NPI Number Information
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NPI Number | 1922504810
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Entity Type | Individual
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Provider Name | ADAM MILES ROSENBERG PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/01/2018
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Last Update Date | 04/01/2018
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Provider Practice Location Address
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Address Line | 87 W OLD COUNTRY RD
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City | HICKSVILLE
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State | NY
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Zip | 11801-4003
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Country | US
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Telephone | 516-433-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 6 OVERLOOK LN
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City | PLAINVIEW
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State | NY
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Zip | 11803-3208
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Country | US
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Telephone | 516-578-2009
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 021948-1
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License Number State | NY
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