MEDICARE: DIONYS JACOB ROSENBAUM MD

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	207W00000X	Ophthalmology Physician	1335431	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235248311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONYS JACOB ROSENBAUM MD

Provider Business Mailing Address
First Line	:	1310 48TH ST
Second Line	:	SUITE 207
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3153
Country	:	US
Telephone Number	:	718-436-8988
Fax Number	:	718-435-8861

Provider Business Practice Location Address
First Line	:	1310 48TH ST
Second Line	:	SUITE 207
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3153
Country	:	US
Telephone Number	:	718-436-8988
Fax Number	:	718-435-8861

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/18/2016

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