MEDICARE: DR. RICK D 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	208200000X	Plastic Surgery Physician	023894	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3261944	OTHER	CT	PROVIDER ID AETNA
2	CV0900	OTHER	CT	PROVIDER ID HEALTHNET
3	607653	OTHER	CT	PROVIDER ID CONNECTICARE
4	P372332	OTHER	CT	PROVIDER ID OXFORD

General Provider Information

NPI Number	:	1588734107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICK D ROSEN M.D.

Provider Business Mailing Address
First Line	:	91 EAST AVE
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-5020
Country	:	US
Telephone Number	:	203-899-0000
Fax Number	:	203-899-0020

Provider Business Practice Location Address
First Line	:	91 EAST AVE
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-5020
Country	:	US
Telephone Number	:	203-899-0000
Fax Number	:	203-899-0020

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. RICK D ROSEN M.D.” Practice Location

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