Provider Demographics
NPI:1164532586
Name:ROSENBERG, GARY S (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:S
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-0722
Mailing Address - Fax:516-683-0184
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-222-0722
Practice Address - Fax:516-683-0184
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY134907207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113141668OtherHORIZON
NY113141668008OtherCIGNA
NY21216815476OtherBEECH STREET
NYOC7423OtherPHS (HEALTHNET)
NY079A9210OtherEMPIRE PLAN
NY113141668OtherMULTI PLAN
NY79A9210OtherBLUE CHOICE
NY0200517OtherGHI
NY305OtherVYTRA
NY4233515OtherAETNA PPO/POS
NY879529OtherAETNA
NYAP325OtherOXFORD
NYABO1127OtherMDNY
NY1226579OtherUNITED HEALTHCARE
NY160022513OtherRR MEDICARE
NYNS0001322OtherSELECT PRO
NY113141668OtherMAGNA CARE
NY17559OtherGHI HMO
NYNS0001322OtherSELECT PRO