Provider Demographics
NPI:1184625485
Name:ROSENN, MARC F (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:F
Last Name:ROSENN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1235 OLD YORK RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3800
Mailing Address - Country:US
Mailing Address - Phone:215-481-4575
Mailing Address - Fax:215-481-4843
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:SUITE 119
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3800
Practice Address - Country:US
Practice Address - Phone:215-481-4575
Practice Address - Fax:215-481-4843
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035510E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012825760014Medicaid
PA131111Medicare ID - Type UnspecifiedINDIV PA MEDICARE NUMBER
PA0012825760014Medicaid