Provider Demographics
NPI:1558342451
Name:ROSENBERG, DAVID B (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:ROSENBERG
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 1:115 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8183
Mailing Address - Country:US
Mailing Address - Phone:212-832-8595
Mailing Address - Fax:212-421-0176
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8183
Practice Address - Country:US
Practice Address - Phone:212-832-8595
Practice Address - Fax:212-421-0176
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198819207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0699706OtherGHI
P2034967OtherOXFORD
NY05Z331Medicare PIN