Provider Demographics
NPI:1376515585
Name:ROSEN, ARTHUR NEIL (OD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:NEIL
Last Name:ROSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LANEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3660
Mailing Address - Country:US
Mailing Address - Phone:508-620-1040
Mailing Address - Fax:
Practice Address - Street 1:13 LANEWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3660
Practice Address - Country:US
Practice Address - Phone:508-620-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2529152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15229OtherBCBS
U076OtherEYEFINITY
MA0328901Medicaid
U076OtherEYEFINITY
MAW15229OtherBCBS
MA153158Medicare PIN