Provider Demographics
NPI:1548378284
Name:ROSENBERG, MICHAEL H (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:NORTH BUILDING, 2ND FLOOR
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-242-7610
Mailing Address - Fax:914-241-3239
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTH BUILDING, 2ND FLOOR
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-242-7610
Practice Address - Fax:914-241-3239
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177236174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF95201Medicare UPIN
ME79J831Medicare ID - Type UnspecifiedMEDICARE ID #