MEDICARE: DR. ELICIA B ROSEN-FOX D.C., C.D.N.

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	111N00000X	Chiropractor	X008264	NY
2	111NN1001X	Nutrition Chiropractor	X008264	NY
3	133N00000X	Nutritionist	005972	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5898131	OTHER	NY	GHI

General Provider Information

NPI Number	:	1356484299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELICIA B ROSEN-FOX D.C., C.D.N.

Provider Business Mailing Address
First Line	:	1432 86TH ST
Second Line	:	REAR OFFICE
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3429
Country	:	US
Telephone Number	:	718-256-6150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 86TH ST
Second Line	:	REAR OFFICE
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3429
Country	:	US
Telephone Number	:	718-256-6150
Fax Number	:

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	09/11/2025

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