Provider Demographics
NPI:1336286855
Name:BARRY N ROSENBAUM MD PA
Entity Type:Organization
Organization Name:BARRY N ROSENBAUM MD PA
Other - Org Name:ASHER, ROSENBAUM & SHARGEL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFC/BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-949-8013
Mailing Address - Street 1:2ND FLOOR
Mailing Address - Street 2:3720 FARRAGUT AVENUE
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2110
Mailing Address - Country:US
Mailing Address - Phone:301-949-8013
Mailing Address - Fax:301-949-8041
Practice Address - Street 1:2ND FLOOR
Practice Address - Street 2:3720 FARRAGUT AVENUE
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2110
Practice Address - Country:US
Practice Address - Phone:301-949-8013
Practice Address - Fax:301-949-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD09834173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD911221900Medicaid
DCC066OtherCAREFIRST BCBS
DCC066OtherCAREFIRST BCBS