Provider Demographics
NPI:1386815041
Name:ROSEN, BRENT R (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:R
Last Name:ROSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ROUTE 202
Mailing Address - Street 2:SUITE 225-230
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-6601
Mailing Address - Country:US
Mailing Address - Phone:215-230-4013
Mailing Address - Fax:215-230-4143
Practice Address - Street 1:3655 ROUTE 202
Practice Address - Street 2:SUITE 225-230
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-6601
Practice Address - Country:US
Practice Address - Phone:215-230-4013
Practice Address - Fax:215-230-4143
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012687207Y00000X
CA20A9828207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology