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General NPI Number Information
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NPI Number | 1932138328
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Entity Type | Individual
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Provider Name | KENNETH ROSENFELD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | HEALTH SCIENCES CENTER L4 #060
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City | STONY BROOK
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State | NY
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Zip | 11794-0001
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Country | US
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Telephone | 631-444-2975
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Fax |
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Provider Business Mailing Address
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Address Line | 12909 GREEN GUAVA AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-7144
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Country | US
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Telephone | 631-804-3125
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 96329
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 161860
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.174124
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 195600
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License Number State | NY
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