Provider Demographics
NPI:1790786192
Name:ROSENBERG, DANIEL EVAN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EVAN
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2300 COMPUTER RD
Mailing Address - Street 2:SUITE H-39
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1752
Mailing Address - Country:US
Mailing Address - Phone:215-657-5200
Mailing Address - Fax:215-657-8083
Practice Address - Street 1:118 WELSH RD UNIT A
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2242
Practice Address - Country:US
Practice Address - Phone:215-657-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425777207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
I26249Medicare UPIN
PA088829Medicare PIN