MEDICARE: DR. ROBERT ARTHUR ROSEN M.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	207RN0300X	Nephrology Physician	G31604	CA

General Provider Information

NPI Number	:	1275714776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ARTHUR ROSEN M.D.

Provider Business Mailing Address
First Line	:	3 MARCIA LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2018
Country	:	US
Telephone Number	:	845-445-1832
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 MARCIA LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2018
Country	:	US
Telephone Number	:	845-445-1832
Fax Number	:

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

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	10/27/2014

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