Provider Demographics
NPI:1003817719
Name:ROSENSWEET, ELLIOTT (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:
Last Name:ROSENSWEET
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1004
Mailing Address - Country:US
Mailing Address - Phone:516-433-3353
Mailing Address - Fax:516-433-8662
Practice Address - Street 1:525 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1004
Practice Address - Country:US
Practice Address - Phone:516-433-3353
Practice Address - Fax:516-433-8662
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2085213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00401547Medicaid
T50642Medicare UPIN
NY00401547Medicaid