Provider Demographics
NPI:1114087699
Name:MICHAEL J. ROSNER, M.D., P.C.
Entity Type:Organization
Organization Name:MICHAEL J. ROSNER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-624-3636
Mailing Address - Street 1:4242 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-1199
Mailing Address - Country:US
Mailing Address - Phone:215-624-3636
Mailing Address - Fax:215-624-9568
Practice Address - Street 1:4242 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-1199
Practice Address - Country:US
Practice Address - Phone:215-624-3636
Practice Address - Fax:215-624-9568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
428120Medicare ID - Type Unspecified