MEDICARE: DR. NED W ROSENGARTEN O.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	152W00000X	Optometrist	4964	OH
2	152W00000X	Optometrist	T1834	OH

General Provider Information

NPI Number	:	1841325669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NED W ROSENGARTEN O.D.

Provider Business Mailing Address
First Line	:	771 S 30TH ST
Second Line	:
City	:	HEATH
State	:	OH
Zip	:	43056-4200
Country	:	US
Telephone Number	:	740-522-2760
Fax Number	:	740-522-3875

Provider Business Practice Location Address
First Line	:	771 S 30TH ST
Second Line	:
City	:	HEATH
State	:	OH
Zip	:	43056-4200
Country	:	US
Telephone Number	:	740-522-2760
Fax Number	:	740-522-2737

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/18/2016

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