Provider Demographics
NPI:1023169240
Name:ROSENFIELD, JOSHUA TRIPP (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:TRIPP
Last Name:ROSENFIELD
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 1:9 LAW ST
Mailing Address - Street 2:
Mailing Address - City:W COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12192-1300
Mailing Address - Country:US
Mailing Address - Phone:518-731-2120
Mailing Address - Fax:518-731-6771
Practice Address - Street 1:9 LAW ST
Practice Address - Street 2:
Practice Address - City:W COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12192-1300
Practice Address - Country:US
Practice Address - Phone:518-731-2120
Practice Address - Fax:518-731-6771
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147503-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00647443Medicaid
000401230004OtherBS OF NENY
000401230004OtherBS OF NENY
NYB78066Medicare UPIN