Provider Demographics
NPI:1063481398
Name:ROSNER, HOWARD MARC (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MARC
Last Name:ROSNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:MARC
Other - Last Name:ROSNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:207 N BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:215-465-3435
Mailing Address - Fax:215-755-4412
Practice Address - Street 1:1809-13 OREGON AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-465-3435
Practice Address - Fax:215-755-4412
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005627L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013792Medicaid
PAD75903Medicare UPIN
PA092129GT6Medicare PIN