Provider Demographics
NPI:1639140486
Name:ROSENFELD, HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:ROSENFELD
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 1:123 GROVE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516
Mailing Address - Country:US
Mailing Address - Phone:516-374-0700
Mailing Address - Fax:516-374-8934
Practice Address - Street 1:123 GROVE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516
Practice Address - Country:US
Practice Address - Phone:516-374-0700
Practice Address - Fax:516-374-8934
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01450715Medicaid
F19933Medicare UPIN
NY01450715Medicaid