MEDICARE: BARRY N ROSENBAUM MD PA

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	173000000X	Legal Medicine	D09834	MD

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
2	C066	OTHER	DC	CAREFIRST BCBS

General Provider Information

NPI Number	:	1336286855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY N ROSENBAUM MD PA

Provider Business Mailing Address
First Line	:	2ND FLOOR
Second Line	:	3720 FARRAGUT AVENUE
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2110
Country	:	US
Telephone Number	:	301-949-8013
Fax Number	:	301-949-8041

Provider Business Practice Location Address
First Line	:	2ND FLOOR
Second Line	:	3720 FARRAGUT AVENUE
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2110
Country	:	US
Telephone Number	:	301-949-8013
Fax Number	:	301-949-8041

Authorized Official
Title or Position	:	OFC/BILLING MGR
Name	:	PATRICIA ARELLANO
Credential	:
Telephone Number	:	301-949-8013

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/12/2010

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