MEDICARE: DR. BRADLEY MICHAEL ROSENFIELD PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1174775126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY MICHAEL ROSENFIELD PSY.D.

Provider Business Mailing Address
First Line	:	1111 MONTGOMERY AVE
Second Line	:
City	:	NARBERTH
State	:	PA
Zip	:	19072
Country	:	US
Telephone Number	:	610-668-1118
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 MARKET ST.
Second Line	:	CENTER FOR COGNITIVE THERAPY, UPENN
City	:	PHILA.
State	:	PA
Zip	:	19104
Country	:	US
Telephone Number	:	215-898-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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