MEDICARE: DR. ALAN J. ROSEN, DPM, PC

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	332B00000X	Durable Medical Equipment & Medical Supplies	N004590-1	NY

General Provider Information

NPI Number	:	1649698515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ALAN J. ROSEN, DPM, PC

Provider Business Mailing Address
First Line	:	5402 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2436
Country	:	US
Telephone Number	:	718-444-3338
Fax Number	:	718-444-4420

Provider Business Practice Location Address
First Line	:	5402 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2436
Country	:	US
Telephone Number	:	718-444-3338
Fax Number	:	718-444-4420

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN JEFFREY ROSEN
Credential	:	DPM
Telephone Number	:	718-444-3338

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	03/28/2014

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