Provider Demographics
NPI:1902001910
Name:ROSENFELD, IRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:
Last Name:ROSENFELD
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 1:18603 MIDLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5826
Mailing Address - Country:US
Mailing Address - Phone:718-969-2094
Mailing Address - Fax:718-969-2459
Practice Address - Street 1:871 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4953
Practice Address - Country:US
Practice Address - Phone:212-570-5217
Practice Address - Fax:718-423-7748
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243678208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery