Provider Demographics
NPI:1568438588
Name:ROSENFELD, RICHARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:BERKSHIRE PEDIATRIC ASSOCIATES PC
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-0838
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:BERKSHIRE PEDIATRIC ASSOCIATES PC SUITE 305
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8531
Practice Address - Fax:413-499-8560
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA44007208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2069016Medicaid
MAI22261Medicare ID - Type Unspecified
MA2069016Medicaid
E03292Medicare UPIN