Provider Demographics
NPI:1912185976
Name:DAVID P. ROSENZWEIG, DPM, PC
Entity Type:Organization
Organization Name:DAVID P. ROSENZWEIG, DPM, PC
Other - Org Name:THE ADVANCED FOOTCARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-937-7077
Mailing Address - Street 1:90 S RIDGE ST
Mailing Address - Street 2:LL7
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2867
Mailing Address - Country:US
Mailing Address - Phone:914-937-7077
Mailing Address - Fax:914-737-7677
Practice Address - Street 1:90 S RIDGE ST
Practice Address - Street 2:LL7
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2867
Practice Address - Country:US
Practice Address - Phone:914-937-7077
Practice Address - Fax:914-737-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003431-0213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00763873Medicaid
CTCO3472Medicare PIN
CTT51096Medicare PIN
NY1325660001Medicare NSC