Provider Demographics
NPI:1194021790
Name:ROSNER, SCOTT J (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:J
Last Name:ROSNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 HANCOCK STREET
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170
Mailing Address - Country:US
Mailing Address - Phone:617-328-6300
Mailing Address - Fax:617-328-7780
Practice Address - Street 1:605 HANCOCK STREET
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170
Practice Address - Country:US
Practice Address - Phone:617-328-6300
Practice Address - Fax:617-328-7780
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010544111N00000X
NYX012137-1111N00000X
MA3368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor