Provider Demographics
NPI:1598707697
Name:ROSENN, GREG (MD)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:ROSENN
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 1:185 EXPRESS ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2406
Mailing Address - Country:US
Mailing Address - Phone:516-777-8800
Mailing Address - Fax:516-777-8806
Practice Address - Street 1:185 EXPRESS ST STE 400
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2406
Practice Address - Country:US
Practice Address - Phone:516-777-8800
Practice Address - Fax:516-777-8806
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1807932084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology