MEDICARE: DR. DAVID MICHAEL 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	268106	NY
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	268106	NY
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	25MA08731600	NJ
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MA08731600	NJ
5	207RP1001X	Pulmonary Disease Physician	268106	NY
6	207RP1001X	Pulmonary Disease Physician	25MA08731600	NJ

General Provider Information

NPI Number	:	1477711349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MICHAEL ROSEN M.D.

Provider Business Mailing Address
First Line	:	7 WILLOW LN
Second Line	:
City	:	TENAFLY
State	:	NJ
Zip	:	07670-2807
Country	:	US
Telephone Number	:	917-701-2747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S DEPT OF
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1119
Country	:	US
Telephone Number	:	718-918-4505
Fax Number	:

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	07/23/2020

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