Provider Demographics
NPI:1568511079
Name:ROSEN, SUSAN I (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:I
Last Name:ROSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAST 65TH STREET
Mailing Address - Street 2:YAFFE RUDEN & ASSOCIATES UP
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-879-4700
Mailing Address - Fax:212-750-9654
Practice Address - Street 1:201 EAST 65TH STREET
Practice Address - Street 2:YAFFE RUDEN & ASSOCIATES UP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-879-4700
Practice Address - Fax:212-750-9654
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2210891208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice