Provider Demographics
NPI:1336107564
Name:ROSENSTEIN, JONATHAN A (MD)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:A
Last Name:ROSENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 BOSTON ROAD
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095
Mailing Address - Country:US
Mailing Address - Phone:413-599-1201
Mailing Address - Fax:413-596-2940
Practice Address - Street 1:2207 BOSTON ROAD
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095
Practice Address - Country:US
Practice Address - Phone:413-599-1201
Practice Address - Fax:413-596-2940
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA74845208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics