Provider Demographics
NPI:1013173996
Name:ROSEN, DANIEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:ROSEN
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 1:200 E 78TH ST
Mailing Address - Street 2:STE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2010
Mailing Address - Country:US
Mailing Address - Phone:646-262-3006
Mailing Address - Fax:
Practice Address - Street 1:200 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-2004
Practice Address - Country:US
Practice Address - Phone:212-288-6380
Practice Address - Fax:212-537-0345
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233866208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery