Provider Demographics
NPI:1558844373
Name:ROSENMEIER, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ROSENMEIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 SLADE ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2228
Mailing Address - Country:US
Mailing Address - Phone:617-908-6213
Mailing Address - Fax:781-899-4515
Practice Address - Street 1:52 SLADE ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2228
Practice Address - Country:US
Practice Address - Phone:617-908-6213
Practice Address - Fax:781-899-4515
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical