Provider Demographics
NPI:1528370251
Name:ROSNER, ANDREW DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DOUGLAS
Last Name:ROSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N. YORK ROAD
Mailing Address - Street 2:HATBORO MEDICAL ASSOCIATES P.C
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19640-0606
Mailing Address - Country:US
Mailing Address - Phone:215-675-1516
Mailing Address - Fax:
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-8520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197669390200000X
PAMD453335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program