Provider Demographics
NPI:1114056447
Name:ROSELL, DANIEL ROBERT (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:ROSELL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 EAST 96TH ST.
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0783
Mailing Address - Country:US
Mailing Address - Phone:917-591-5211
Mailing Address - Fax:212-831-6909
Practice Address - Street 1:17 E 96TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0783
Practice Address - Country:US
Practice Address - Phone:917-591-5211
Practice Address - Fax:212-831-6909
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2418922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry