Provider Demographics
NPI:1073920468
Name:ROSENFELD, SHLOMO KALMAN (RT(T))
Entity Type:Individual
Prefix:MR
First Name:SHLOMO
Middle Name:KALMAN
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:RT(T)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LEFFERTS AVE APT D1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1221
Mailing Address - Country:US
Mailing Address - Phone:718-839-3499
Mailing Address - Fax:
Practice Address - Street 1:750 LEFFERTS AVE APT D1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1221
Practice Address - Country:US
Practice Address - Phone:718-839-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5416672471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy