MEDICARE: DR. NEIL B ROSENBAUM D.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	1223G0001X	General Practice Dentistry	033996	NY

General Provider Information

NPI Number	:	1326150012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL B ROSENBAUM D.M.D.

Provider Business Mailing Address
First Line	:	2001 MARCUS AVE
Second Line	:	SUITE 112 NORTH
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1011
Country	:	US
Telephone Number	:	516-326-3300
Fax Number	:	516-326-3303

Provider Business Practice Location Address
First Line	:	2001 MARCUS AVE
Second Line	:	SUITE 112 NORTH
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1011
Country	:	US
Telephone Number	:	516-326-3300
Fax Number	:	516-326-3303

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/08/2010

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